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

Alper Ceylan Ahmet Köybaşıoğlu Korhan Asal Yusuf Kızıl Erdoğan İnal

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.

Keywords

Deglutition disorders/surgery/prevention & control, glottis, laryngeal muscles/physiology/surgery, laryngeal neoplasms/surgery, laryngectomy/methods, neck dissection, pharyngeal muscles/innervation, pharynx/surgery

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

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

Keywords

Yutma bozukluklar›/cerrahi/önleme ve konrol, glottis, larenks kaslar›/fizyoloji/cerrahi, larenks neoplazileri/cerrahi, larenjektomi/yöntem, boyun diseksiyonu, farenks kaslar›/inervasyon, farenks/cerrahi.

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