Alteration in esophageal motility after laryngectomy

Duranceau, André; Jamieson, Glyn G.; Hurwitz, Aryeh; Jones, Rachel; Postlethwait, R. W.

doi:10.1016/0002-9610(76)90416-5

Cited by 62 publications

(47 citation statements)

References 12 publications

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“…Choi et al [9] and Duranceau et al [19] showed marked derangements in the UES function and the oesophageal body after laryngectomy. The injuries of the pharyngeal branches of the vagus nerve and/or of the superior laryngeal nerves, reported by Duranceau et al [19] as possible causes of oesophageal dismotility, are very rare during pneumonectomy, as well as the destruction of the pharyngo-oesophageal junction responsible for swallowing. Thus, the exact neuromuscular basis to explain the alteration of UES resting pressure after pneumonectomy is not clear and requires further evaluation.…”

Section: Discussionmentioning

confidence: 97%

The effects of lung resection on physiological motor activity of the oesophagus†

Fiorelli

Vicidomini

Milione

et al. 2013

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES:To assess the modifications of oesophageal function after major lung resection and whether these modifications are correlated with the extent of resection ( pneumonectomy vs others). METHODS:In the last 5 years, 40 consecutive surgical patients with lung cancer were prospectively enrolled and divided in two groups: Group A (n = 20) patients scheduled for elective pneumonectomy and Group B (n = 20) for more limited resections (lobectomy or bilobectomy). In addition to routine evaluations, all patients underwent preoperative (within 5 days) and postoperative (6 months) oesophageal manometry to assess the lower oesophageal sphincter (LES), the oesophageal body and the upper oesophageal sphincter functions. Symptoms scoring questionnaires were recorded for each patient and the oesophageal dislocation assessed by radiological examinations.RESULTS: Thirty-three (15 of Group A and 18 of Group B) patients completed the study. After operation, we found that LES resting pressure was significantly lower in Group A compared with Group B (P = 0.01); conversely, the relaxing pressure resulted as being higher in Group A than in Group B (P = 0.01). In Group A compared with Group B, a significant reduction of amplitude and that of wave duration of oesophageal contractions were seen at the upper (0.0001 and 0.02, respectively), middle (0.0003 and 0.002, respectively) and lower (0.0001 and 0.0004, respectively) oesophageal body. In addition, 12 of 15 (80%) patients of Group A and 3 of 18 (17%) of Group B presented a lack of regular peristaltic movement (P = 0.001). Despite chest CT scan showing a shift of the oesophagus in 11 of 15 (73%) and 2 of 18 (11.1%) patients of Groups A and B (P = 0.001), the oesophagus dislocation resulted 'severe' on barium swallow study in only two patients of Group A. The manometric alterations were subclinical; heartburn was recorded in three patients (two of Group A and one of Group B) and epigastric pain in four (two for each group). No other symptoms were observed.CONCLUSIONS: Pneumonectomy may cause significant oesophageal motility disorders that are mostly subclinical. Thus, this type of surgery should not be denied to patients if required to treat their cancer.

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Section: Discussionmentioning

confidence: 97%

The effects of lung resection on physiological motor activity of the oesophagus†

Fiorelli

Vicidomini

Milione

et al. 2013

European Journal of Cardio-Thoracic Surgery

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“…Radiation can alter the ability to swallow by causing xerostomia, fibrosis, cranial nerve damage and restriction of laryngeal elevation [17] . Having a TL will prevent aspiration of food, but will lead to lack of coordination between the pharyngeal constrictors and upper esophageal sphincter [18,19] . Although chemotherapy was only given to 3 patients in this study in the postoperative setting, it can potentiate the radiation and thus increase the toxicity of RT.…”

Section: Discussionmentioning

confidence: 99%

Proximal Esophageal Stenosis in Head and Neck Cancer Patients after Total Laryngectomy and Radiation

Vu¹,

Day²,

Gillespie³

et al. 2008

ORL

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Background: There has been an increasing focus on late functional effects of head and neck cancer (HNC) treatment. This study was undertaken to evaluate the incidence of late proximal esophageal stricture in patients undergoing total laryngectomy (TL) and radiation therapy (RT). Material and Methods: An institutional retrospective review of HNC patients treated between 1995 and 2003 with TL and RT was undertaken. Thirty-three patients with stage II–IV disease were included; 25 patients had TL and postoperative RT (group 1), while 8 patients had definitive RT with salvage laryngectomy (group 2). Results: The median follow-up was 28 months. At the last follow-up, 25 patients (76%) were alive and disease free. Four had died and 3 developed distant metastasis. Dysphagia or stenosis developed in 40% in group 1 and 75% in group 2 patients. The median time to dysphagia was 5.5 months for all patients. Conclusions: The incidence of esophageal stenosis was 33% for all patients. Contributing factors for esophageal stenosis after TL and RT include continued alcohol and tobacco use, the dose-volume relationship of the RT and normal tissue damage from the tumor and the treatment.

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“…A pouch of variable size is seen on the anterosuperior surface of the neopharynx, marking the top of the suture line I20]. At approximately the C4 vertebral level, a mass effect of variable size indents the posterior surface of the neopharynx; this represents the bunched cricopharyngeal and inferior constrictor muscles [20][21][22]. On the anteroposterior view, the neopharynx may deviate gently from the midline.…”

Section: Surgical Considerationsmentioning

confidence: 99%

“…Finally, esophageal motility disturbances may be an important contributor to symptomatic dysphagia [21]. It has been shown that postlaryngectomy patients exhibit markedly diminished contraction pressures within the esophageal body, and that up to one-fourth of the peristaltic waves are abnormal.…”

Section: Surgical Considerationsmentioning

confidence: 99%

Dysphagia after laryngeal surgery: Radiologic assessment

Balfe

1990

Dysphagia

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Alteration in esophageal motility after laryngectomy

Cited by 62 publications

References 12 publications

The effects of lung resection on physiological motor activity of the oesophagus†

The effects of lung resection on physiological motor activity of the oesophagus†

Proximal Esophageal Stenosis in Head and Neck Cancer Patients after Total Laryngectomy and Radiation

Dysphagia after laryngeal surgery: Radiologic assessment

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