Postoperative dysphagia immediately following pediatric endoscopic laryngeal cleft repair

Abstract INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

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Preoperative predictors of dysphagia after transoral surgery

International Journal of Clinical Oncology ◽

10.1007/s10147-021-01860-9 ◽

2021 ◽

Author(s):

Kazunori Fujiwara ◽

Kenkichiro Taira ◽

Ryohei Donishi ◽

Satoshi Koyama ◽

Tsuyoshi Morisaki ◽

...

Keyword(s):

Head And Neck ◽

Forced Expiratory Volume ◽

Transoral Surgery ◽

Postoperative Dysphagia ◽

Swallowing Function ◽

History Of ◽

Group A ◽

Low Bmi ◽

Head And Neck Radiotherapy

Abstract Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the preoperative predictive factors for postoperative dysphagia in patients undergoing TOS. Methods One hundred and twenty patients who underwent TOS were evaluated in this study. The degree of dysphagia was evaluated using the Functional Outcome Swallowing Scale (FOSS) both preoperatively and 3 months postoperatively. Those whose FOSS stage was maintained postoperatively were classified into the FOSS-M group, while those with increased FOSS stage postopratively were classified into the FOSS-I group. The following parameters were assessed before surgery: age, weight, height, body mass index (BMI), forced expiratory volume in 1 s, and history of head and neck radiotherapy. Videofluoroscopy (VF) was performed preoperatively to evaluate swallowing function using the Penetration-Aspiration Scale (PAS). Results The BMI of the FOSS-M group was significantly higher than that of the FOSS-I group. A history of radiotherapy was significantly more common in the FOSS-I group than in the FOSS-M group. Finally, preoperative PAS in the FOSS-M group was lower than that in the FOSS-I group. Conclusion This study suggested that patients with preoperative aspiration detected using VF might develop postoperative dysphagia severely. In addition, preoperative low BMI and a history of previous radiotherapy for head and neck cancer were associated with postoperative dysphagia. Objective examinations such as VF should be performed preoperatively.

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Endoscopic repair of laryngeal cleft

Operative Techniques in Otolaryngology-Head and Neck Surgery ◽

10.1016/j.otot.2016.04.007 ◽

2016 ◽

Vol 27 (2) ◽

pp. 100-103 ◽

Cited By ~ 1

Author(s):

Ozgul Gergin ◽

Reza Rahbar ◽

Eelam Adil

Keyword(s):

Endoscopic Repair ◽

Laryngeal Cleft

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Anterior submucous laryngeal cleft

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/s0165-5876(00)00346-3 ◽

2000 ◽

Vol 54 (2-3) ◽

pp. 153-158 ◽

Cited By ~ 1

Author(s):

C.Anthony Hughes ◽

Kathryn A Miller ◽

Lauren D Holinger ◽

Robert P Miller

Keyword(s):

Laryngeal Cleft

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Laryngeal Cleft

Multidisciplinary Management of Pediatric Voice and Swallowing Disorders ◽

10.1007/978-3-030-26191-7_27 ◽

2019 ◽

pp. 269-283

Author(s):

Karthik Balakrishnan ◽

Kari A. Krein

Keyword(s):

Laryngeal Cleft

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Development and validation of a quality of life instrument for patients with laryngeal cleft

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2018.02.041 ◽

2018 ◽

Vol 108 ◽

pp. 143-150 ◽

Cited By ~ 4

Author(s):

Alexandria L. Irace ◽

Ryan D. Walker ◽

Kosuke Kawai ◽

Meaghan Maddock ◽

Natasha D. Dombrowski ◽

...

Keyword(s):

Quality Of Life ◽

Life Instrument ◽

Laryngeal Cleft ◽

Development And Validation

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Risk Factors for Dysphagia After Anterior Cervical Discectomy and Fusion With the Zero-P Implant System: a Retrospective Study With Minimum of 2 Years Follow-up

10.21203/rs.3.rs-138933/v1 ◽

2021 ◽

Author(s):

Rong Xue ◽

Ningdao Li ◽

Zhurong Ji ◽

Xingdong Cheng ◽

Zhuqiu Zhang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Operation Time ◽

Anterior Cervical Discectomy ◽

Postoperative Dysphagia ◽

Chi Square ◽

Chi Square Test ◽

Implant System ◽

Segmental Angle

Abstract Background: Dysphagia is one of the most common complications after anterior cervical spine surgery. The study aimed to evaluate the risk factors for dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia. Methods: A retrospective analysis of 260 patients who underwent ACDF with the Zero-P Implant System and had at least 2 year of follow-up ware performed. All patients were divided into a non-dysphagia group and a dysphagia group. Sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue thickness, the levels of surgery, O-C2 angle, C2–7 angle, T1 slope and segmental angle were analyzed. Chi-square test and logistic regression were performed to analyze the predictive value of each dimension for dysphagia. Results: In total, the non-dysphagia group comprised 170 patients and the dysphagia group comprised 90 patients. Chi-square test results indicated that number of operated levels, operation time dT1 slope, dO-C2 angle, dC2–7 angle, segmental angle and dPSTT were associated with a high incidence of dysphagia. Multivariate logistic regression analysis showed that number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia.Conclusions: Number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia. In additionally, sufficient preoperative preparation, evaluation combining with proficient and precise treatment measures are suggested to reduce the incidence of postoperative dysphagia when ACDF is performed.

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Role of preoperative cervical alignment on postoperative dysphagia after occipitocervical fusion

Surgical Neurology International ◽

10.25259/sni_547_2021 ◽

2021 ◽

Vol 12 ◽

pp. 350

Author(s):

Midori Miyagi ◽

Hiroshi Takahashi ◽

Hideki Sekiya ◽

Satoru Ebihara

Keyword(s):

Rank Correlation ◽

Oral Intake ◽

Postoperative Dysphagia ◽

Occipitocervical Fusion ◽

Cervical Alignment ◽

Pharyngeal Airway ◽

Before And After ◽

Functional Oral Intake Scale ◽

Relationship Of

Background: Dysphagia is one of the most serious complications of occipitocervical fusion (OCF). The previous studies have shown that postoperative cervical alignment, documented with occipito (O)-C2 angles, C2-C6 angles, and pharyngeal inlet angles (PIA), impacted the incidence of postoperative dysphagia in patients undergoing OCF. Here, we investigated the relationship of preoperative versus postoperative cervical alignment on the incidence of postoperative dysphagia after OCF. Methods: We retrospectively reviewed the clinical data/medical charts for 22 patients following OCF (2006– 2019). The O-C2 angles, C2-C6 angles, PIA, and narrowest pharyngeal airway spaces (nPAS) were assessed using plain lateral radiographs of the cervical spine before and after the surgery. The severity of dysphagia was assessed with the functional oral intake scale (FOIS) levels as documented in medical charts; based on this, patients were classified into the nondysphagia (FOIS: 7) versus dysphagia (FOIS: 1–6) groups. Results: Seven patients (35%) experienced dysphagia after OCF surgery. Preoperative PIA and nPAS were smaller in the dysphagia group. Spearman rank correlation showed a positive correlation between preoperative PIA and FOIS and between preoperative nPAS and FOIS. Conclusion: This study suggests that preoperative cervical alignment may best predict the incidence of postoperative dysphagia after OCF.

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