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The effects of pharyngeal neurectomy and cricopharyngeal myotomy on postoperative deglutition in patients undergoing horizontal supraglottic laryngectomy

Year 2003, Volume: 11 Issue: 6, 170 - 174, 24.12.2003

Abstract

Objectives: We compared the effects of pharyngeal neurectomy PN and cricopharyngeal myotomy CPM on postoperative deglutition in patients undergoing hori­ zontal supraglottic laryngectomy HSL .Patients and Methods: The study included 20 male patients mean age 53 years; range 39 to 67 years who unden/vent HSL for squamous celi carcinoma of the larynx.Tumor stages were in two, T2 in 16 , and T3 in two patients. None had received radiotherapy before surgery. İn orderto decrease cricopharyngeal muscle spasm follovving HSL, the patients were randomly chosen for CPM n=11 and PN n=9 . The two groups were compared with respect to the time to postoperative oral food intake.Results: No significant difference was found with respect to the time to postoperative oral feeding mean 27 days, range 16 to 45 days in the CPM group; mean 25 days, range 16 to 36 days in the PN group; p>0.05 . No signif­ icant relationship existed betvveen primary tumor stages and the time to oral feeding p>0.05 . No complications were encountered in the two patient groups.Conclusion: İn supraglottic partial laryngectomies, PN seems to be as effective as CPM to decrease p o s t o p- erative cricopharyngeal muscle spasm, with additional advantages of ease and safety.

References

  • Bocca E, Pignataro O, Oldini C. Supraglottic laryngecto- my: 30 years of experience. Ann Otol Rhinol Laryngol 1983;92(1 Pt 1):14-8.
  • Burstein FD, Calcaterra TC. Supraglottic laryngecto- my: series report and analysis of results. Laryngoscope 1985;95(7 Pt 1):833-6.
  • Som ML. Conservation surgery for carcinoma of the supraglottis. J Laryngol Otol 1970;84:655-78.
  • Ogura JH. Supraglottic subtotal laryngectomy and radical neck dissection for carcinoma of the epiglottis. Laryngoscope 1958;68:983-1003.
  • Ogura JH, Biller HF. Conservation surgery in cancer of the head and neck. Otolaryngol Clin North Am 1969; 2:641-65.
  • Mitchell RL, Armanini GB. Cricopharyngeal myoto- my: treatment of dysphagia. Ann Surg 1975;181:262-6.
  • Lauerma KS, Harvey JE, Ogura JH. Cricopharyngeal myotomy in subtotal supraglottic laryngectomy: an experimental study. Laryngoscope 1972;82:447-53.
  • Sasaki CT, Joe JK, Albert S. Efficacy of adjunctive cricopharyngeus myotomy in supraglottic laryngecto- my. Dysphagia 2001;16:19-22.
  • Singer MI, Blom ED, Hamaker RC. Pharyngeal plexus n e u rectomy for alaryngeal speech re h a b i l i t a t i o n . Laryngoscope 1986;96:50-4.
  • Blom ED, Pauloski BR, Hamaker RC. Functional out- come after surgery for prevention of pharyngospasms in tracheoesophageal speakers. Part I: Speech charac- teristics. Laryngoscope 1995;105:1093-103.
  • Jacob P, Kahrilas PJ, Logemann JA, Shah V, Ha T. Upper esophageal sphincter opening and modula- tion during swallowing. Gastro e n t e rology 1989;97: 1 4 6 9 - 7 8 .
  • Cook IJ, Dodds WJ, Dantas RO, Massey B, Kern MK, Lang IM, et al. Opening mechanisms of the human upper esophageal sphincter. Am J Physiol 1989;257(5 Pt 1): G 7 4 8 - 5 9 .
  • Litton WB, Leonard JR. Aspiration after partial laryn- gectomy: cineradiographic studies. Laryngoscope 1969;79:887-908.
  • Staple TW, Ogura JH. Cineradiography of the swallow- ing mechanism following supraglottic subtotal laryngec- t o m y. Radiology 1966;87:226-30.
  • Flores TC, Wood BG, Levine HL, Koegel L Jr, Tucker HM. Factors in successful deglutition following supra- glottic laryngeal surgery. Ann Otol Rhinol Laryngol 1982;91(6 Pt 1):579-83.
  • McConnel FM, Mendelsohn MS, Logemann JA. Manofluorography of deglutition after supraglottic laryngectomy. Head Neck Surg 1987;9:142-50.
  • Wasserman T, Murry T, Johnson JT, Myers EN. Management of swallowing in supraglottic and extended supraglottic laryngectomy patients. Head Neck 2001;23:1043-8.
  • Hirano M, Kurita S, Tateishi M, Matsuoka H. Deglutition following supraglottic horizontal laryn- g e c t o m y. Ann Otol Rhinol Laryngol 1987;96(1 Pt 1): 7 - 11 .
  • Ogura JH, Saltzstein SL, Spjut HJ. Experiences with conservation surgery in laryngeal and pharyngeal car- cinoma. Laryngoscope 1961;71:258-76.
  • Jacobs JR, Logemann J, Pajak TF, Pauloski BR, Collins S, Casiano RR, et al. Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer s u rg e r y. Arch Otolaryngol Head Neck Surg 1999;125: 9 4 2 - 6 .
  • Chodosh PL. Cricopharyngeal myotomy in the treat- ment of dysphagia. Laryngoscope 1975;85(11 pt 1): 1862-73.
  • Sessions DG, Zill R, Schwartz SL. Deglutition after conservation surgery for cancer of the larynx and hypopharynx. Otolaryngol Head Neck Surg 1979;87: 779-96.
  • Campbell BH, Tuominen TC, Toohill RJ. The risk and complications of aspiration following cricopharyngeal myotomy. Am J Med 1997;103:61S-3.
  • Mahieu HF, Annyas AA, Schutte HK, Van der Jagt EJ. Pharyngoesophageal myotomy for vocal rehabilitation of laryngectomees. Laryngoscope 1987;97:451-7.
  • Scott PM, Bleach NR, Perry AR, Cheesman AD. Complications of pharyngeal myotomy for alaryngeal voice rehabilitation. J Laryngol Otol 1993;107:430-3.
  • Spiegel JR, Albright JT. The failure of cricopharyngeal myotomy to improve postoperative dysphagia: is video- f l u o roscopic diagnosis adequate? Arch Otolaryngol Head Neck Surg 2000;126:804-5.

Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri

Year 2003, Volume: 11 Issue: 6, 170 - 174, 24.12.2003

Abstract

Amaç: Horizontal supraglottik larenjektomi HSL uygulanan hastalarda farenjeal nörektomi FN ile krikofarenjeal miyotominin KFM ameliyat sonrası yutmafonksiyonu üzerine etkileri karflılafltırıldı.Hastalar ve Yöntemler: Çalıflmaya yassı epitel hücrelilarenks karsinomu nedeniyle HSL uygulanan 20 erkekhasta alındı. Olguların ikisinde T1, 16’sında T2, ikisinde T3tümör vardı. Hiçbirine ameliyat öncesinde radyoterapi uygulanmamıfltı. Krikofarenjeal kas spazmını azaltmak amacıyla, HSL ile birlikte rastgele seçimle 11 hastaya KFM, dokuzuna FN uygulandı.İki hasta grubu ameliyat sonrası dönemde ağızdan beslenmeye bafllama zamanı açısından karflılafltırıldı. Bulgul a r : Ağızdan gıda alımına bafllama süresi iki gruparasında anlamlı farklılık göstermedi KFM grubunda ortalama 27 gün, dağılım 16-45 gün; FN grubunda 25 gün,dağılım 16-36 gün; p>0.05 . Primer tümörün evresi ileoral gıda alımına bafllama süresi arasında da anlamlı iliflki saptanmadı p>0.05 . İki yöntemde de herhangi birkomplikasyonla karflılaflılmadı.Sonuç: Supraglottik parsiyel larenjektomilerde krikofarenjeal kas spazmını azaltmada daha kolay ve güvenlibir yöntem olan FN’nin KFM kadar etkili olduğu sonucuna varıldı

References

  • Bocca E, Pignataro O, Oldini C. Supraglottic laryngecto- my: 30 years of experience. Ann Otol Rhinol Laryngol 1983;92(1 Pt 1):14-8.
  • Burstein FD, Calcaterra TC. Supraglottic laryngecto- my: series report and analysis of results. Laryngoscope 1985;95(7 Pt 1):833-6.
  • Som ML. Conservation surgery for carcinoma of the supraglottis. J Laryngol Otol 1970;84:655-78.
  • Ogura JH. Supraglottic subtotal laryngectomy and radical neck dissection for carcinoma of the epiglottis. Laryngoscope 1958;68:983-1003.
  • Ogura JH, Biller HF. Conservation surgery in cancer of the head and neck. Otolaryngol Clin North Am 1969; 2:641-65.
  • Mitchell RL, Armanini GB. Cricopharyngeal myoto- my: treatment of dysphagia. Ann Surg 1975;181:262-6.
  • Lauerma KS, Harvey JE, Ogura JH. Cricopharyngeal myotomy in subtotal supraglottic laryngectomy: an experimental study. Laryngoscope 1972;82:447-53.
  • Sasaki CT, Joe JK, Albert S. Efficacy of adjunctive cricopharyngeus myotomy in supraglottic laryngecto- my. Dysphagia 2001;16:19-22.
  • Singer MI, Blom ED, Hamaker RC. Pharyngeal plexus n e u rectomy for alaryngeal speech re h a b i l i t a t i o n . Laryngoscope 1986;96:50-4.
  • Blom ED, Pauloski BR, Hamaker RC. Functional out- come after surgery for prevention of pharyngospasms in tracheoesophageal speakers. Part I: Speech charac- teristics. Laryngoscope 1995;105:1093-103.
  • Jacob P, Kahrilas PJ, Logemann JA, Shah V, Ha T. Upper esophageal sphincter opening and modula- tion during swallowing. Gastro e n t e rology 1989;97: 1 4 6 9 - 7 8 .
  • Cook IJ, Dodds WJ, Dantas RO, Massey B, Kern MK, Lang IM, et al. Opening mechanisms of the human upper esophageal sphincter. Am J Physiol 1989;257(5 Pt 1): G 7 4 8 - 5 9 .
  • Litton WB, Leonard JR. Aspiration after partial laryn- gectomy: cineradiographic studies. Laryngoscope 1969;79:887-908.
  • Staple TW, Ogura JH. Cineradiography of the swallow- ing mechanism following supraglottic subtotal laryngec- t o m y. Radiology 1966;87:226-30.
  • Flores TC, Wood BG, Levine HL, Koegel L Jr, Tucker HM. Factors in successful deglutition following supra- glottic laryngeal surgery. Ann Otol Rhinol Laryngol 1982;91(6 Pt 1):579-83.
  • McConnel FM, Mendelsohn MS, Logemann JA. Manofluorography of deglutition after supraglottic laryngectomy. Head Neck Surg 1987;9:142-50.
  • Wasserman T, Murry T, Johnson JT, Myers EN. Management of swallowing in supraglottic and extended supraglottic laryngectomy patients. Head Neck 2001;23:1043-8.
  • Hirano M, Kurita S, Tateishi M, Matsuoka H. Deglutition following supraglottic horizontal laryn- g e c t o m y. Ann Otol Rhinol Laryngol 1987;96(1 Pt 1): 7 - 11 .
  • Ogura JH, Saltzstein SL, Spjut HJ. Experiences with conservation surgery in laryngeal and pharyngeal car- cinoma. Laryngoscope 1961;71:258-76.
  • Jacobs JR, Logemann J, Pajak TF, Pauloski BR, Collins S, Casiano RR, et al. Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer s u rg e r y. Arch Otolaryngol Head Neck Surg 1999;125: 9 4 2 - 6 .
  • Chodosh PL. Cricopharyngeal myotomy in the treat- ment of dysphagia. Laryngoscope 1975;85(11 pt 1): 1862-73.
  • Sessions DG, Zill R, Schwartz SL. Deglutition after conservation surgery for cancer of the larynx and hypopharynx. Otolaryngol Head Neck Surg 1979;87: 779-96.
  • Campbell BH, Tuominen TC, Toohill RJ. The risk and complications of aspiration following cricopharyngeal myotomy. Am J Med 1997;103:61S-3.
  • Mahieu HF, Annyas AA, Schutte HK, Van der Jagt EJ. Pharyngoesophageal myotomy for vocal rehabilitation of laryngectomees. Laryngoscope 1987;97:451-7.
  • Scott PM, Bleach NR, Perry AR, Cheesman AD. Complications of pharyngeal myotomy for alaryngeal voice rehabilitation. J Laryngol Otol 1993;107:430-3.
  • Spiegel JR, Albright JT. The failure of cricopharyngeal myotomy to improve postoperative dysphagia: is video- f l u o roscopic diagnosis adequate? Arch Otolaryngol Head Neck Surg 2000;126:804-5.
There are 26 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Alper Ceylan This is me

Ahmet Köybaşıoğlu This is me

Korhan Asal This is me

Yusuf Kızıl This is me

Erdoğan İnal This is me

Publication Date December 24, 2003
Published in Issue Year 2003 Volume: 11 Issue: 6

Cite

APA Ceylan, A., Köybaşıoğlu, A., Asal, K., Kızıl, Y., et al. (2003). Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri. The Turkish Journal of Ear Nose and Throat, 11(6), 170-174.
AMA Ceylan A, Köybaşıoğlu A, Asal K, Kızıl Y, İnal E. Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri. Tr-ENT. December 2003;11(6):170-174.
Chicago Ceylan, Alper, Ahmet Köybaşıoğlu, Korhan Asal, Yusuf Kızıl, and Erdoğan İnal. “Horizontal Supraglottik Larenjektomi Uygulanan Hastalarda Farenjeal nörektomi Ve Kriko Faren Jeal Miyotominin Ameliyat Sonrası Yutma Fonksiyonu üzerine Etkileri”. The Turkish Journal of Ear Nose and Throat 11, no. 6 (December 2003): 170-74.
EndNote Ceylan A, Köybaşıoğlu A, Asal K, Kızıl Y, İnal E (December 1, 2003) Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri. The Turkish Journal of Ear Nose and Throat 11 6 170–174.
IEEE A. Ceylan, A. Köybaşıoğlu, K. Asal, Y. Kızıl, and E. İnal, “Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri”, Tr-ENT, vol. 11, no. 6, pp. 170–174, 2003.
ISNAD Ceylan, Alper et al. “Horizontal Supraglottik Larenjektomi Uygulanan Hastalarda Farenjeal nörektomi Ve Kriko Faren Jeal Miyotominin Ameliyat Sonrası Yutma Fonksiyonu üzerine Etkileri”. The Turkish Journal of Ear Nose and Throat 11/6 (December 2003), 170-174.
JAMA Ceylan A, Köybaşıoğlu A, Asal K, Kızıl Y, İnal E. Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri. Tr-ENT. 2003;11:170–174.
MLA Ceylan, Alper et al. “Horizontal Supraglottik Larenjektomi Uygulanan Hastalarda Farenjeal nörektomi Ve Kriko Faren Jeal Miyotominin Ameliyat Sonrası Yutma Fonksiyonu üzerine Etkileri”. The Turkish Journal of Ear Nose and Throat, vol. 11, no. 6, 2003, pp. 170-4.
Vancouver Ceylan A, Köybaşıoğlu A, Asal K, Kızıl Y, İnal E. Horizontal supraglottik larenjektomi uygulanan hastalarda farenjeal nörektomi ve kriko faren jeal miyotominin ameliyat sonrası yutma fonksiyonu üzerine etkileri. Tr-ENT. 2003;11(6):170-4.