Journal article
Preliminary Evaluation of Functional Swallow After Total Laryngectomy Using High-Resolution Manometry
Annals of otology, rhinology & laryngology, Vol.125(7), pp.541-549
07/01/2016
DOI: 10.1177/0003489416629978
PMCID: PMC5300062
PMID: 26868604
Abstract
Introduction: Understanding of swallowing pressures after total laryngectomy (TL) and what constitutes a "functional" swallow are limited. Mobile structures are altered or removed after TL, with consequent effects on pressure profiles. High-resolution manometry (HRM) can characterize these pressures.
Methods: Six TL subjects without dysphagia and 6 controls underwent pharyngeal HRM. Timing and pressure variables for the velopharynx, mesopharynx, and upper esophageal sphincter (UES) were compared. Changes in variables due to bolus volume were evaluated in TL subjects.
Results: The TL subjects had increased duration of velopharyngeal pressure (P = .012). Maximum mesopharyngeal pressure was lower versus controls (P = .003). Maximal and total pre-opening (P = .002, P = .002) and post-closure (P = .001, P = .002) UES pressures were lower. Maximum mesopharyngeal pressure (P = .032) decreased with increasing bolus volume.
Conclusions: Increased velopharyngeal pressure duration and total swallow duration reflect separation of the pharynx into distinct conduits for air and food, thus ensuring successful bolus passage without the need for respiration. Decreased UES pressure highlights the effects of disrupting the cricopharyngeal and rostral esophageal muscle fibers from their attachments to the larynx and performing a cricopharyngeal myotomy. Additional studies including subjects with dysphagia could further characterize the functional TL swallow and identify aspects susceptible to dysfunction.
Details
- Title: Subtitle
- Preliminary Evaluation of Functional Swallow After Total Laryngectomy Using High-Resolution Manometry
- Creators
- Dylan Lippert - University of Wisconsin–MadisonMatthew R. Hoffman - Highland Community College - IllinoisChristopher J. Britt - University of Wisconsin–MadisonCorinne A. Jones - University of Wisconsin–MadisonJodi Hernandez - University of Wisconsin–MadisonMichelle R. Ciucci - University of Wisconsin–MadisonTimothy M. McCulloch - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Annals of otology, rhinology & laryngology, Vol.125(7), pp.541-549
- DOI
- 10.1177/0003489416629978
- PMID
- 26868604
- PMCID
- PMC5300062
- NLM abbreviation
- Ann Otol Rhinol Laryngol
- ISSN
- 0003-4894
- eISSN
- 1943-572X
- Publisher
- Sage
- Number of pages
- 9
- Grant note
- R33 DC011130 / National Institutes of Health grant from the National Institute on Deafness and other Communicative Disorders R33DC011130 / NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD)
- Language
- English
- Date published
- 07/01/2016
- Academic Unit
- Communication Sciences and Disorders; Otolaryngology
- Record Identifier
- 9984366377702771
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