Proximal Esophageal Contractions in Laryngectomized Patients

Abstract

After laryngectomy for treatment of laryngeal cancer, the distal esophageal contractions have low amplitude. Our hypothesis is that proximal esophageal contractions are also impaired. We studied the proximal esophageal contractions in 20 laryngectomized patients (16 men) with a mean age of 44.2 years, 12 rehabilitated patients with esophageal speech, and 12 controls (7 men, mean age of 46.5 years). We used the manometric method with continuous perfusion. All subjects were studied in the sitting position and performed five swallows of a 5-ml bolus of water alternated with five dry swallows. The contractions were measured 2 cm below the high-pressure zone of the pharyngoesophageal transition. The results showed that the amplitude and duration of contractions were different in laryngectomized patients compared with controls. The amplitude of contractions of patients (wet swallows: 37.3+/-20.7 mmHg, mean+/-SD) was lower than that of controls (81.1+/-31.7 mmHg). The duration of contractions was also lower in laryngectomized patients (2.2+/-0.7 s) than in controls (2.6+/-0.6 s). We conclude that the proximal esophageal contraction amplitude and duration of laryngectomized patients are lower than controls, a fact suggesting that laryngectomy may affect the proximal esophageal contractions.

Correlation of Maximum Phonation Time and Vocal Intensity With Intraluminal Esophageal and Pharyngoesophageal Pressure in Total Laryngectomees

“…[1][2][3] After extirpation of the larynx, the upper digestive tract (pharynx and esophagus) will account for alaryngeal vocal production in a secondary and compensatory manner. [1][2][3] After extirpation of the larynx, the upper digestive tract (pharynx and esophagus) will account for alaryngeal vocal production in a secondary and compensatory manner.…”

Dysphagia Evaluation and Treatment After Head and Neck Surgery and/or Chemo-radiotherapy for Head and Neck Malignancies

“…Esophageal motility impairment has been found in patients after TL ( Fig. 13): the amplitude of contractions is lower, and the number of nonperistaltic contractions is higher; besides, the duration of lower esophageal sphincter relaxation is shorter and the upper esophageal sphincter pressure is lower in laryngectomized patients than in control subjects (Dantas et al 2002;Dantas et al 2005). …”

Variation in surgical methods used for total laryngectomy in Australia

“…peristalsis, required to propel the food bolus through to the oesophagus on swallowing). 5 Reduced sensation in the reconstructed pharynx is also expected, due to sectioning of the superior and recurrent laryngeal nerves.…”

“…5 A stenosis or constriction at the level of the reconstructed pharyngo-oesophageal segment may occur, resulting in significant impairment of the hypopharynx, with food and/or fluid residue remaining at this site after swallowing.…”

“…(5) Are there other aspects of your surgical closure that you believe are important (such as direction of closure, suture technique, etc)? Please describe.…”