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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: yutomo.s@kitasato-u.ac.jp 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

References

Laccourreye, H, Laccourreye, O, Weinstein, G, Menard, M, Brasnu, D. Supracricoid laryngectomy with cricohyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma. Ann Otol Rhinol Laryngol 1990;99:421–6CrossRefGoogle ScholarPubMed
Nakayama, M, Laccourreye, O, Holsinger, FC, Okamoto, M, Hayakawa, K. Functional organ preservation for laryngeal cancer: past, present and future. Jpn J Clin Oncol 2012;42:155–60CrossRefGoogle ScholarPubMed
Weinstein, GS, El-Sawy, MM, Ruiz, C, Dooley, P, Chalian, A, El-Sayed, MM et al. Laryngeal preservation with supracricoid partial laryngectomy results in improved quality of life when compared with total laryngectomy. Laryngoscope 2001;111:191–9CrossRefGoogle ScholarPubMed
Naudo, P, Laccourreye, O, Weinstein, G, Hans, S, Laccourreye, H, Brasnu, D. Functional outcome and prognosis factors after supracricoid partial laryngectomy with cricohyoidopexy. Ann Otol Rhinol Laryngol 1997;106:291–6CrossRefGoogle ScholarPubMed
Cho, KJ, Joo, YH, Sun, DI, Kim, MS. Supracricoid laryngectomy: oncologic validity and functional safety. Eur Arch Otorhinolaryngol 2010;267:1919–25CrossRefGoogle ScholarPubMed
Farrag, TY, Koch, WM, Cummings, CW, Goldenberg, D, Abou-Jaoude, PM, Califano, JA et al. Supracricoid laryngectomy outcomes: the Johns Hopkins experience. Laryngoscope 2007;117:129–32CrossRefGoogle ScholarPubMed
Nakayama, M, Yao, K, Nishiyama, K, Nagai, H, Ito, A, Yokobori, S et al. Swallowing function after near-total laryngectomy, cricohyoidoepiglottopexy (CHEP), and cricohyoidopexy (CHP). Nihon Jibiinkoka Gakkai Kaiho 2002;105:8–13CrossRefGoogle Scholar
Benito, J, Holsinger, FC, Perez-Martin, A, Garcia, D, Weinstein, GS, Laccourreye, O. Aspiration after supracricoid partial laryngectomy: incidence, risk factors, management, and outcomes. Head Neck 2011;33:679–85CrossRefGoogle Scholar
Chevalier, D, Piquet, JJ. Subtotal laryngectomy with cricohyoidopexy for supraglottic carcinoma: review of 61 cases. Am J Surg 1994;168:472–3CrossRefGoogle ScholarPubMed
Piquet, JJ, Chevalier, D. Subtotal laryngectomy with crico-hyoido-epiglotto-pexy for the treatment of extended glottic carcinomas. Am J Surg 1991;162:357–61CrossRefGoogle ScholarPubMed
Alajmo, E, Fini-Storchi, O, Agostini, V, Polli, G. Conservation surgery for cancer of the larynx in the elderly. Laryngoscope 1985;95:203–5CrossRefGoogle ScholarPubMed
Alicandri-Ciufelli, M, Piccinini, A, Bergamini, G, Ruberto, M, Ghidini, A, Marchioni, D et al. Atypical neoglottis after supracricoid laryngectomy: a morphological and functional analysis. Eur Arch Otorhinolaryngol 2011;268:1029–34CrossRefGoogle ScholarPubMed
Kendall, KA, Leonard, RJ. Dysphagia assessment and treatment planning: a team approach. In: Dynamic Swallow Study: Objective Measures and Normative Data in Adults. San Diego: Plural Publishing, 2007;233–94Google Scholar
Yutomo, S, Shunsuke, M, Meijin, N, Taku, Y. A kinematic analysis of swallow gestures and timing using videofluoroscopic study after supracricoid laryngectomy. Radiol Diagn Imaging 2020;4:1–7Google Scholar
Kendall, KA, McKenzie, S, Leonard, RJ, Goncalves, MI, Walker, A. Timing of events in normal swallowing: a videofluoroscopic study. Dysphagia. 2000;15:74–83CrossRefGoogle ScholarPubMed
Akbas, Y, Demireller, A. Oncologic and functional results of supracricoid partial laryngectomy with cricohoidopexy. Otolaryngol Head Neck Surg 2005;132:783–7CrossRefGoogle Scholar
Yüce, Y, Çaglı, S, Bayram, A, Karasu, F, Satı, I, Güney, E. The effect of arytenoid resection on functional results of cricohyoidopexy. Otolaryngolol Head Neck Surg 2009;141:272–5CrossRefGoogle ScholarPubMed
Leonard, R, McKenzie, S. Hyoid-bolus transit latencies in normal swallow. Dysphagia 2006;21:183–90CrossRefGoogle ScholarPubMed
Leonard, RJ, Kendall, KA, Johnson, R, McKenzie, S. Swallowing in myotonic muscular dystrophy: a videofluoroscopic study. Arch Phys Med Rehabil 2001;82:979–85CrossRefGoogle ScholarPubMed
Leonard, R, Rees, CJ, Belafsky, P, Allen, J. Fluoroscopic surrogate for pharyngeal strength: the pharyngeal constriction ratio (PCR). Dysphagia 2011;26:13–7CrossRefGoogle Scholar
Yip, H, Leonard, R, Belafsky, PC. Can a fluoroscopic estimation of pharyngeal constriction predict aspiration? Otolaryngol Head Neck Surg 2006;135:215–7CrossRefGoogle ScholarPubMed
Logemann, JA, Rademaker, AW, Pauloski, BR, Lazarus, CL, Mittal, BB, Brockstein, B et al. Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck 2006;28:64–73CrossRefGoogle ScholarPubMed
Pellini, R, Manciocco, V, Spriano, G. Functional outcome of supracricoid partial laryngectomy with cricohyoidopexy: radiation failure vs previously untreated cases. Arch Otolaryngol Head Neck Surg 2006;132:1221–5CrossRefGoogle ScholarPubMed
Marioni, G, Marchese-Ragona, R, Pastore, A, Staffieri, A. The role of supracricoid laryngectomy for glottic carcinoma recurrence after radiotherapy failure: a critical review. Acta Otolaryngol 2006;126:1245–51CrossRefGoogle ScholarPubMed
Allen, J, White, CJ, Leonard, R, Belafsky, PC. Effect of cricopharyngeus muscle surgery on the pharynx. Laryngoscope. 2010;120:1498–503CrossRefGoogle ScholarPubMed