title: [Swallowing function after near-total laryngectomy, cricohyoidoepiglottopexy (CHEP), and cricohyoidopexy (CHP)].
abstract: We studied postoperative swallowing in 4 patients undergoing CHEP and 1 undergoing CHP. Swallowing was obtained by intense swallowing rehabilitation since only 1/4 of the larynx remained after near-total laryngectomy. Our swallowing rehabilitation program is detailed in this paper. The improvement of swallowing is classified into 3 stages. In stage I, volus directly intrudes into the trachea. In stage II, volus stagnates between laryngeal inlet and tracheal stoma. In stage III, volus directly flows through the esophageal inlet. Stage III indicates that rehabilitation is almost completed. Stage I is shortest at 2 to 14 days and Stage II longest at 7 to 80 days. The MTF (Method, Time, Food) score described by Fujimoto et al was used to analyze swallowing. Three cases following CHEP showed high scores shortly after the introduction of rehabilitation and reached the maximum score at discharge (15 points = normal swallowing). At present, these 3 patients are satisfied with swallowing and enjoy a good quality of life. In 2 other cases (1 CHEP and 1 CHP), both had a wide laryngeal inlet and still have some difficulty with liquids. Further modification of the surgical technique is needed especially for CHP.
authors.affiliation: Department of Otorhinolaryngology, Kitasato University School of Medicine, Sagamihara.
authors.forename: Meijin
authors.initials: M
authors.lastname: Nakayama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yao
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nagai
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ito
authors.forename: Satoru
authors.initials: S
authors.lastname: Yokobori
authors.forename: Makito
authors.initials: M
authors.lastname: Okamoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Hirose
mesh_terms: D000368:Aged; D003413:Cricoid Cartilage / Q000601:surgery*; D003679:Deglutition / Q000502:physiology*; D004825:Epiglottis / Q000601:surgery*; D006801:Humans; D006928:Hyoid Bone; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged