Radiological analysis of swallowing and functional outcomes after hypopharyngo-laryngectomy with reconstruction using a jejunal autograft.

Abstract:

CONCLUSION:We report a distinct pattern of tongue movement. This is interpreted as a compensatory mechanism after hypopharyngo-laryngectomy with reconstruction using a jejunal autograft. Passage through the oesophagus is mainly passive. OBJECTIVE:Swallowing is normally initiated voluntarily, and afterwards presumed to be controlled by brainstem reflexes. Resection of the hypopharynx with reconstruction may affect this control. This study attempted to perform a biomechanical analysis of the motility in the small bowel graft and suggest possible implications for surgical management. We also analysed how oesophageal passage is affected by surgery. METHODS:Five patients underwent a radiological examination of the neopharyngeal conduit and oesophagus and completed a simple questionnaire. RESULTS:The radiological examinations revealed a distinct pattern of tongue movement in all patients, resulting in varying degrees of thrust. Passage through the jejunal graft was mainly passive, but observations of progressive reduction in diameter of the graft indicated muscular tone that may preserve pressure generated by the lingual thrust. The oesophageal transport appeared to be rather passive and largely depended upon the effect of gravity. Two of five patients were unable to eat normal food. Their impaired swallowing resulted in severely reduced quality of life.

journal_name

Acta Otolaryngol

journal_title

Acta oto-laryngologica

authors

Bakkan N,Boysen ME,Line PD,Aasen S

doi

10.3109/00016481003664785

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

1077-83

issue

9

eissn

0001-6489

issn

1651-2251

journal_volume

130

pub_type

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