Factors in Successful Deglutition following Supraglottic Laryngeal Surgery

1982 ◽  
Vol 91 (6) ◽  
pp. 579-583 ◽  
Author(s):  
Toribio C. Flores ◽  
Benjamin G. Wood ◽  
Lawrence Koegel ◽  
Howard L. Levine ◽  
Harvey M. Tucker
Keyword(s):  
Cricopharyngeal Myotomy ◽  
Swallowing Function ◽  
Cricopharyngeal Muscle ◽  
Base Of Tongue ◽  
Laryngeal Surgery ◽  
Laryngeal Inlet ◽  
Base Of The Tongue

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.

scholarly journals Hamartomatous lesion at the base of tongue: A rare entity

2021 ◽  
Vol 6 (3) ◽  
pp. 223-225
Author(s):  
Neelam Gupta ◽  
Ankush Blaggan ◽  
Vikas Dubey ◽  
Mehak Kashyap ◽  
Nechal Kaur
Keyword(s):  
Histopathological Examination ◽  
Rare Entity ◽  
Base Of Tongue ◽  
Base Of The Tongue

Hamartomas are benign proliferative lesions with no metastatic properties. The hamartoma of the tongue is usually rare. It is usually difficult to diagnose grossly. But can be diagnosed definitely with help of histopathological examination. Our case study is on a 5-year-old female who was asymptomatic and presented with cystic swelling at the base of the tongue which was initially diagnosed as a cyst but was diagnosed histopathologically as a hamartoma.

Swallowing Function Following Extensive Resection of Oral or Oropharyngeal Cancer With Laryngeal Suspension and Cricopharyngeal Myotomy

2007 ◽  
Vol 117 (8) ◽  
pp. 1343-1348 ◽  
Author(s):  
Yasushi Fujimoto ◽  
Yasuhisa Hasegawa ◽  
Hiroko Yamada ◽  
Atsushi Ando ◽  
Tsutomu Nakashima
Keyword(s):  
Oropharyngeal Cancer ◽  
Cricopharyngeal Myotomy ◽  
Swallowing Function ◽  
Extensive Resection

Deglutition following Supraglottic Horizontal Laryngectomy

1987 ◽  
Vol 96 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Minoru Hirano ◽  
Morio Tateishi ◽  
Shigejiro Kurita ◽  
Hidetaka Matsuoka
Keyword(s):  
Neck Dissection ◽  
Hyoid Bone ◽  
Thyroid Cartilage ◽  
Radical Neck Dissection ◽  
Vocal Folds ◽  
Arytenoid Cartilage ◽  
Cricopharyngeal Myotomy ◽  
Clinical Records ◽  
Horizontal Laryngectomy ◽  
Base Of The Tongue

In order to determine factors that may contribute to deglutition problems following supraglottic horizontal laryngectomy or its modified techniques, clinical records of 38 patients were studied. Contribution of the following factors was investigated: Age; sex; tumor classification; radical neck dissection; extent of and symmetry in removal of the aryepiglottic folds, arytenoid cartilages, and false folds; removal of the base of the tongue, hyoid bone, and a part of the vocal folds; extent of removal of the epiglottis and thyroid cartilage; cricopharyngeal myotomy; and some complications and concomitant diseases. The results suggest that removal of the arytenoid cartilage and asymmetrical removal of the false folds contribute to deglutition problems. We conclude that the standard supraglottic horizontal laryngectomy associated with surgical approximation of the larynx to the base of the tongue and cricopharyngeal myotomy does not usually cause serious deglutition problems. When the arytenoid cartilage is removed, reconstruction of the structure is required for the prevention of severe aspiration.

Improvement of Dysphagia following Cricopharyngeal Myotomy in a Group of Elderly Patients

1995 ◽  
Vol 104 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Jean Lacau St Guily ◽  
Henri Copin ◽  
Kai-Xin Zhang ◽  
Gillian S. Butler-Browne ◽  
Sophie Périé ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Elderly Patients ◽  
Inflammatory Cell ◽  
Specific Treatment ◽  
Inflammatory Cell Infiltration ◽  
Degenerative Changes ◽  
Cell Infiltration ◽  
Muscle Dysfunction ◽  
Cricopharyngeal Myotomy ◽  
Cricopharyngeal Muscle

Cricopharyngeal myotomy is not effective in all cases of dysphagia. However, it should be the specific treatment in cases of dysphagia caused by a primary cricopharyngeal muscle dysfunction. Of a group of 10 patients with swallowing disorders in the absence of any defined cause, 7 (mean age, 81.6 years) were improved by a myotomy and 3 were not. The cricopharyngeal muscle was studied histologically and biochemically and compared to muscle obtained from nondysphagic subjects. In the muscle of the 7 improved patients, homogeneous histologic abnormalities were demonstrated: connective tissue infiltration, inflammatory cell infiltration, and degenerative changes of the muscle fibers. Conversely, muscles of the nonimproved patients and of the controls did not present the same degree of histologic lesions.

scholarly journals Swallowing Function in Patients With Base of Tongue Cancers Treated With Primary Surgery and Reconstructed With a Modified Radial Forearm Free Flap

2008 ◽  
Vol 134 (8) ◽  
pp. 857 ◽  
Author(s):  
Daniel Ambrose O’Connell ◽  
Jana Rieger ◽  
Jeffrey Richard Harris ◽  
Peter Dziegielewski ◽  
Jana Zalmanowitz ◽  
...  
Keyword(s):  
Free Flap ◽  
Radial Forearm Free Flap ◽  
Swallowing Function ◽  
Base Of Tongue ◽  
Primary Surgery ◽  
Radial Forearm

Radiographic Findings after Cricopharyngeal Myotomy

1987 ◽  
Vol 28 (5) ◽  
pp. 555-558 ◽  
Author(s):  
O. Ekberg ◽  
J. Besjakov ◽  
S. Lindgren
Keyword(s):  
Contrast Medium ◽  
Cervical Esophagus ◽  
Pharyngocutaneous Fistula ◽  
Cricopharyngeal Myotomy ◽  
Radiographic Findings ◽  
Cricopharyngeal Muscle ◽  
Postoperative Changes ◽  
Mucosal Perforation

Single film examinations (iodine and/or barium) were reviewed in 28 patients who had undergone surgery on the cricopharyngeal muscle due to Zenker diverticula (24 patients), cricopharyngeal muscle incoordination (3 patients) and pharyngoesophageal web (one patient). All patients had had a myotomy which included the cricopharyngeal muscle and up to 3 cm of the cervical esophagus. Lateral and anterior deviation of the pharynx and cervical esophagus occurred regularly. A pharyngocutaneous fistula developed in 2 patients which healed within 3 weeks. In 5 patients there was a posterior leak of contrast medium during the first postoperative week which healed within 2 weeks. Six of these seven patients with a fistula or a leak had had either a diverticulum removed or sustained an accidental mucosal perforation. No patient had recurrence of diverticula, although, 9 patients developed a cricopharyngeal muscle impression. Iodine and barium examinations are important for monitoring early and late postoperative changes after cricopharyngeus myotomy.

scholarly journals Acinic Cell Carcinoma of Minor Salivary Gland of the Base of Tongue That Required Reconstructive Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Kota Wada ◽  
Subaru Watanabe ◽  
Yuji Ando ◽  
Yoichi Seino ◽  
Hiroshi Moriyama
Keyword(s):  
Salivary Gland ◽  
Cell Carcinoma ◽  
Reconstructive Surgery ◽  
Minor Salivary Gland ◽  
Acinic Cell Carcinoma ◽  
Swallowing Function ◽  
Acinic Cell ◽  
Base Of Tongue ◽  
Pull Through ◽  
Emergency Tracheotomy

Acinic cell carcinoma of minor salivary gland of the base of tongue is very rare. Squamous cell carcinoma is the most common tumor in the base of tongue. We present a patient with gigantic acinic cell carcinoma of the base of tongue. This patient required emergency tracheotomy before surgery, because he had dyspnea when he came to our hospital. We removed this tumor by pull-through method and performed reconstructive surgery using a rectus abdominis myocutaneous flap. It was a case that to preserved movement of the tongue and swallowing function by keeping lingual arteries and hypoglossal nerves. This case was an extremely rare case of ACC of the base of tongue that required reconstructive surgery.

Efficacy of fluoroscopy-guided endoscopic cricopharyngeal myotomy

2018 ◽  
Vol 132 (12) ◽  
pp. 1128-1133 ◽  
Author(s):  
K Fujiwara ◽  
K Kawamoto ◽  
K Taira ◽  
T Fukuhara ◽  
S Koyama ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Balloon Catheter ◽  
Extent Of Resection ◽  
Complication Rates ◽  
Cricopharyngeal Myotomy ◽  
Operative Morbidity ◽  
Cricopharyngeal Muscle ◽  
Operative Complications ◽  
Scale Scores ◽  
Penetration Aspiration Scale

AbstractBackgroundIn endoscopic cricopharyngeal myotomy, surgeons sometimes have concerns about performing an adequate incision with only a narrow intra-cavital view from one direction. In order to overcome these issues, fluoroscopic radiography was used during endoscopic cricopharyngeal myotomy.MethodsPeri-operative fluoroscopic radiography was utilised to check the position of the diverticuloscope, and to confirm the extent of the incision during surgery. A balloon catheter was used to determine whether the cricopharyngeal muscle was sufficiently resected. Blood loss, peri-operative complications, and functional oral swallowing scale and penetration aspiration scale scores were evaluated.ResultsIn 12 out of 15 patients, intra-operative fluoroscopic radiography showed the diverticuloscope positioned in the post-cricoid area, and the cricopharyngeal muscle was raised and the surgery completed without adverse effect. Swallowing functions improved following surgery.ConclusionIntra-operative fluoroscopy might improve endoscopic cricopharyngeal myotomy by allowing surgeons to confirm the extent of resection, and by reducing peri-operative morbidity and complication rates.

scholarly journals Transmandibular and transcervical surgical approach in treatment of tongue base cancers - ten-year results

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 12-19
Author(s):  
Rajko Jovic ◽  
Danijela Dragicevic ◽  
Karol Canji ◽  
Jugoslav Gasic ◽  
Masa Djozic
Keyword(s):  
Survival Rate ◽  
Tongue Cancer ◽  
Distant Metastases ◽  
Functional Results ◽  
Second Primary ◽  
Swallowing Function ◽  
Patients With Cancer ◽  
Base Of Tongue ◽  
Neck Metastases ◽  
Transmandibular Approach

Introduction. The aim of this study was to present oncological and functional results of surgical treatment of the base of tongue cancer by analyzing retrospectively 115 patients treated during a ten-year period. During this period, 150 patients with cancer of the base of tongue were diagnosed, which accounts for 5.6% of all diagnosed head and neck cancers and 24.1% of all oropharyngeal cancers. In 111 patients (96.5%), planocellular carcinoma with various degrees of differentiation was pathohistologically verified. Neck metastases were found in 88 (76.5%) patients. Advanced III and IV stages of disease were verified in 92.9% of patients (stage III in 23.4%, IV A in 59.1%, IV % B in 10.4%). Transmandibular approach was performed in 5.2% of patients, while 94.8% of patients were approached through pharynx The defects were covered by primary reconstruction; the pectoralis major myocutaneous flap was used in 4 patients . During immediate postoperative period, 17 (14.7%) patients developed complications: bleeding occurred in 7 patients (6%), fistula and wound infection developed in 5 (4.3%) and 11 (9.5%) patients, respectively. Postoperatively, 61 (53%) patients were treated by radiation therapy. Swallowing function was resumed in all patients except in three, who underwent gastrostomy due to the lesion of both hypoglossal nerves. Gasrostoma was closed after six months when swallowing was resumed. Local and regional recurrence developed in 13 (11.3%) and 24 (20.8%) patients, respectively, and distant metastases developed in 4 (3.5%) patients. Second primary cancer was diagnosed in 9 (7.8%) patients Disease-specific 3-year survival rate (according to the T category) was 73%, 60%, 45% and 21% in patients with T1, T2, T3 and T4, respectively. Diseasespecific 3-year survival rate (according to category N) was 68% in N0 and 32%) in N +. The overall 3-year survival rate was 42%.

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