Faculty Collaboration Database

Mechanisms of recovery of swallow after supraglottic laryngectomy. J Speech Hear Res 1994 Oct;37(5):965-74

Date

10/01/1994

Pubmed ID

7823564

DOI

10.1044/jshr.3705.965

Scopus ID

2-s2.0-0027981165 (requires institutional sign-in at Scopus site)   63 Citations

Abstract

This study examines oropharyngeal swallow disorders and measures of pharyngeal and laryngeal movement during deglutition from videofluorographic studies of oropharyngeal swallow in 9 patients who had undergone supraglottic laryngectomy and 9 age-matched normal subjects. The swallows of surgical patients were examined at 2 weeks and 3 months postoperatively. Two critical factors in recovery of swallowing were identified: (a) airway closure at the laryngeal entrance, that is, the space between the arytenoid cartilage and the base of the tongue, and (b) the movement of the tongue base to make complete contact with the posterior pharyngeal wall. When patients achieved these two functions, they returned to normal swallowing. The duration of tongue base contact to the posterior pharyngeal wall and extent of anterior movement of the arytenoid increased significantly from 2 weeks to 3 months in the surgical patients. At 2 weeks postsurgery, patients who had undergone supraglottic laryngectomy exhibited significantly shorter airway closure and tongue base to pharyngeal wall contact, reduced laryngeal elevation, increased width of cricopharyngeal (CP) opening, and later onset of airway closure and tongue base movement than normal subjects. These significant differences remained at 3 months postoperatively, although swallow measures were moving toward normal in the patients who had undergone supraglottic laryngectomy. Comparison of patients not eating at 2 weeks with patients at the time of first eating revealed significantly longer duration of tongue base contact to the pharyngeal wall, longer duration of airway closure, and greater movement of the arytenoid in patients who were eating. Results indicate that the focus of swallowing therapy after supraglottic laryngectomy should be on improvement of posterior movement of the tongue base and anterior tilting of the arytenoid to close the airway entrance and improve bolus propulsion (in the case of the tongue base).

Author List

Logemann JA, Gibbons P, Rademaker AW, Pauloski BR, Kahrilas PJ, Bacon M, Bowman J, McCracken E

Author

Barbara R. Pauloski PhD, CCC-SLP Associate Professor in the Communication Sciences & Disorders department at University of Wisconsin - Milwaukee

MESH terms used to index this publication - Major topics in bold

Barium Sulfate
Case-Control Studies
Deglutition
Deglutition Disorders
Fluoroscopy
Follow-Up Studies
Humans
Laryngectomy
Larynx
Matched-Pair Analysis
Middle Aged
Pharynx
Time Factors
Tongue
Videotape Recording