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Characteristics that predict laryngeal penetration and aspiration in elderly patients following supracricoid laryngectomy with cricohyoidoepiglottopexy: a videofluoroscopic study

Published online by Cambridge University Press:  27 October 2021

Y Seino ,
S Miyamoto ,
M Nakayama ,
T Yamashita ,
A Miles  and
J E Allen
Y Seino*
Affiliation:
Department of Otorhinolaryngology, Kitasato University School of Medicine, Tokyo, Japan
S Miyamoto
Affiliation:
Department of Otorhinolaryngology, Kitasato University School of Medicine, Tokyo, Japan
M Nakayama
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Yokohama City University, Japan
T Yamashita
Affiliation:
Department of Otorhinolaryngology, Kitasato University School of Medicine, Tokyo, Japan
A Miles
Affiliation:
Speech Science, School of Psychology, New Zealand
J E Allen
Affiliation:
Department of Surgery, The University of Auckland, New Zealand
*
Author for correspondence: Dr Y Seino, Department of Otorhinolaryngology-HNS, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 252-0374, Japan E-mail: [email protected] Fax: +81 42 778 8441
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Abstract

Objective

This study aimed to determine the incidence of laryngeal penetration and aspiration in elderly patients who underwent supracricoid laryngectomy with cricohyoidoepiglottopexy for laryngeal cancer.

Method

A retrospective analysis of dynamic videofluoroscopic swallowing studies was performed in patients who had received supracricoid laryngectomy with cricohyoidoepiglottopexy as a treatment for laryngeal cancers. Digital analysis of videofluoroscopic swallowing studies included measurements of displacement and timing related to swallowing safety.

Results

Videofluoroscopic swallowing studies from 52 patients were analysed. All participants were male and over 65 years old. Studies were performed five years after surgery. Among 52 videofluoroscopic swallowing studies, analysis showed that elevated pharyngeal constriction ratio (pharyngeal constriction ratio more than 0.0875, odds ratio = 5.2, p = 0.016), reduced pharyngoesophageal sphincter opening time (pharyngoesophageal sphincter open less than 0.6 seconds, odds ratio = 11.6, p = 0.00018) and reduced airway closure time (airway close less than 0.6 seconds, odds ratio = 10.6, p = 0.00057) were significantly associated with aspiration.

Conclusion

Deteriorated pharyngeal constriction, shortened airway closure and reduced pharyngoesophageal sphincter opening time are key factors for predicting laryngeal penetration or aspiration after supracricoid laryngectomy with cricohyoidoepiglottopexy.

Keywords

Laryngeal NeoplasmsDeglutitionDiagnostic Imaging PharynxHyoid BoneArytenoid CartilageRehabilitation
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 5 , May 2022 , pp. 439 - 446
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr Y Seino takes responsibility for the integrity of the content of the paper

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