Functional Endoscopic Evaluation of Swallowing in Patients Treated by Total Laryngectomy and Adjuvant Treatment for Advanced Laryngeal and Hypopharyngeal Malignancies

In this study 32 patients treated by laryngectomy with partial pharyngectomy and adjuvant radiotherapy underwent fibreoptic endoscopic evaluation of swallowing at 6 and 12  weeks after completion of treatment. Majority of them had delayed transit of bolus, dryness and edema and 6 of them had pharyngeal stenosis, 2 had fibrotic band and 2 had adynamic pharyngeal segments. These findings were the cause of dysphagia. The frequency of occurrence of the above findings and their association with extent of resection of pharyngeal mucosa and adjuvant treatment have been documented. Bilateral neck dissection, post operative chemotherapy with radiotherapy and use of myocutaneous flap for the reconstruction of neopharynx were found to cause severe dysphagia in our series. Some of these patients benefitted by swallowing therapy, diet modifications and nasogastric feeding. Therefore early identification of cause of dysphagia in these patients and timely intervention to facilitate rehabilitation can improve the quality of life and reduce the long term morbidity in thes e patients.
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research