title: [Digital cineradiography of the pharynx and the oesophagus after total or partial laryngectomy].
abstract: OBJECTIVE
  The aim of the present study is to report our experience using digital cineradiography to assess morphological and functional disorders of the pharynx in patients with prior partial or total laryngectomy.
  
  
  METHODS
  From March 2000 to October 2002, 21 patients (18 males and 3 females) with prior total laryngectomy (12 patients), total laryngopharyngectomy (2 patients) and partial laryngectomy (7 patients) were examined. A digital cineradiography with 12 frames/second acquisition was performed in all patients. In four patients the procedure was interrupted for massive barium aspiration, without cough (silent aspiration). In 17 patients standing in the left posterior oblique position and prone in the right posterior oblique position the oesophagus and oesophagogastric junction were also examined. The water siphon test was performed at the end of the procedure. Small boluses (10 ml) of liquid (60% w/v) and high-density (250% w/v) barium, barium paste (110% w/v), and solid meal (obtained spreading a dry biscuit with barium paste) were used.
  
  
  RESULTS
  All patients with prior total laryngectomy and total laryngopharyngectomy showed morphological and functional disorders of the neopharynx: parapharyngeal diverticulum (2 cases), submandibular pouch (6 cases), fistulas (2 cases), lumen narrowing and post-surgical stenoses (2 cases), tumour recurrence (1 case), prominent cricopharynx (5 cases) and rhinopharyngeal reflux (4 cases). All patients with prior partial laryngectomy (7 cases) presented silent aspiration. Eleven patients had an oesophageal motility disorder, which was very serious in three of them with decrease in oesophageal clearing and barium retention in the oesophagus. Oesophagogastric junction evaluation showed hiatus hernia in six cases, two of them with associated gastro-oesophageal reflux.
  
  
  CONCLUSIONS
  Digital cineradiography appears able to identify the organic and functional postoperative complications of patient treated with partial or total laryngectomy. A special swallowing study can suggest to the speech therapist the best compensatory mechanism for improving patient swallowing and therefore quality of life.
authors: Dipartimento di Medicina Legale e Biotecnologie, Sezione di Scienze Radiologiche, Istituto di Radiogia, Azienda Universitaria-Ospedaliera Policlinico, Palermo. barbiera@inwind.it
authors: Filippo
authors: F
authors: Barbiera
authors: Eugenio
authors: E
authors: Fiorentino
authors: Vito
authors: V
authors: Lo Greco
authors: Massimo
authors: M
authors: Galia
authors: Giuseppe Antonio
authors: GA
authors: Musto
authors: Giuseppe
authors: G
authors: Runza
authors: Fortunato
authors: F
authors: Sorrentino
authors: Gianvincenzo
authors: G
authors: Sparacia
authors: Antonio
authors: A
authors: Lo Casto
mesh_terms: D000328:Adult; D000368:Aged; D002933:Cineradiography / Q000379:methods*; D003680:Deglutition Disorders / Q000503:physiopathology / Q000601:surgery; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000000981:diagnostic imaging* / Q000503:physiopathology