[Computerized manometry and deglutition after pharyngolaryngeal tumor resections].
33 patients were examined after laryngopharyngeal surgery by means of computer manometry using 4-channel-pressure probes. After local tumour resection in the region of tonsils and lateral oropharyngeal wall a slight cranial decrease in pressure results. Resections of the soft palate, glossotonsillar groove, base of the tongue, and of the vallecula lead to a cranial release of pressure reducing the driving force of the tongue. The swallowing action is therefore delayed and completely uncoordinated resulting in dyskinesia of the PE segment. Stenosis in the PE segment after hypopharyngeal resections increases the resistance to bolus transfer. If the base of the tongue is intact the obstruction can be compensated. After laryngectomy the sphincter pressure is decreased reducing the hypopharyngeal suction pump and prolonging bolus transfer. The tongue driving force, however, is increased. As long as the base of the tongue region is intact, pressure is not released and bolus transfer not severely impaired despite missing contraction of the pharyngeal constrictor muscle. Thus, reconstructive procedures after ablative pharyngeal surgery have to provide more "high-volume-tissue" in the base of the tongue (i.e. myocutaneous pectoral flap) in order to initiate swallowing and avoid cranial release of pressure whereas in the PE-segment more "low-volume-tissue" is necessary (i.e. myofascial pectoral flap) to facilitate bolus transfer.
Walther
E K
EK
Universitäts-Hals-Nasen-Ohren-Klinik, Bonn.
Herberhold
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000503:physiopathology*; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007830:Larynx / Q000503:physiopathology; D008297:Male; D008365:Manometry / Q000295:instrumentation*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D010614:Pharynx / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology*; D012086:Reoperation; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*
Computermanometrie und Schluckfunktion nach pharyngolaryngealen Tumorresektionen.