[Diagnosis and therapy of dysphagia after partial horizontal laryngectomy]

Due to an increase in the numbers of function-preserving laryngectomies and the utilization of laser techniques in cancer surgery, more patients after supraglottic partial laryngectomies are experiencing dysphagia of different intensities. We therefore developed a functional therapy program that we use for patients after supraglottic partial laryngectomies following a special diagnostic evaluation including video-laryngoscopy and, if necessary, high-speed cine-radiography. This therapeutic treatment was developed from conventional treatment for patients with dysphagia caused by neurological disorders and includes body posture, altered mouth movements, food consistency and swallowing technique. In so doing, exercises are used to achieve closure of the vocal folds, aids for swallowing liquids and general directions. This method for evaluation and treatment is presented in 12 patients as examples. We now report our positive long-term results and demonstrate the possibilities and limits of therapy. Additional procedures for isolated cases are discussed critically with regard to their indications and treatment.