Aspiration is the major problem in deglutition associated with conservation laryngeal surgery. Closure of the glottic sphincter, depression of the epiglottis over the laryngeal inlet, elevation of the thyrohyoid complex under cover of the base of the tongue and appropriate relaxation of the cricopharyngeal muscle to permit unobstructed passage of food into the esophagus are important mechanisms that prevent food from entering the trachea. Partial laryngeal surgery can interfere with one or a combination of these mechanisms. Analysis of the records of all evaluable patients who underwent horizontal supraglottic resections from January 1976 to June 1981 was undertaken. The incidence of deglutition problems is reported. In addition, the effects of resection or preservation of the hyoid, arytenoid, base of tongue and branches of the vagus and the effect of cricopharyngeal myotomy upon ultimate swallowing function are analyzed.

Globus hystericus means the "hysterical ball or lump in the throat," and is generally assumed to be of psychic origin. True dysphagia is usually absent. Twelve patients with the globus syndrome were studied at the Esophageal Motility Laboratory of the Saint Luke's Hospital of Cleveland. An organic cause for their symptomatology was ruled out by physical examination, laryngoscopy, esophagoscopy and cineesophagograms. Ten patients showed significant elevations in esophageal resting pressures and nine had evidence of disordered motor activity in the body of the esophagus. Knowing from previous investigations that a suprasternal discomfort may be elicited from stimulation of the esophagus at different levels, we propose that the globus sensation is a referred one coming from the hypertonic and frequently incoordinated body of the esophagus.

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