Functional study of the voice and swallowing following supracricoid laryngectomy.
To identify the grade and evolution of dysphagia and dysphonia in patients undergoing supracricoid laringectomy, and to study the association of these findings with clinical and surgical variables.


METHODS
The study included 22 cases undergoing supracricoid laringectomy at the Head and Neck Surgery and Otolaryngology Department of the Heliopolis Hospital - Brasil, and referred to speech therapy. Dysphagia and dysphonia were correlated with gender, age, stage T (T1, T2, T3, T4), primary site (supraglottis, glottis or subglottis), preservation of one or two arytenoids, reconstructive procedures (cricohyoidopexy or cricohyoidoepiglotopexy), time to withdraw the naso-enteral tube, and time to close the tracheostomy. Statistical tests included the Chi-square and/or Fischers exact test.


RESULTS
We observed an association between moderate grade dysphagia and the glottis as the primary site, cricohyoidoepiglotopexy as the type of reconstruction and naso-enteral tube removal within one month after the surgery. There was also an association between severe dysphagia and the supraglottis as the primary site. Dysphagia and dysphonia were associated in the degree of severity; however a larger number of patients had better progression of dysphagia compared to the progression of dysphonia. There was no statistical significance between other associations.


CONCLUSIONS
Improvement of swallowing is more frequent than improvement of dysphagia. There is an association between moderate dysphagia and the glotttis as primary site, cricohyoidoepiglotopexy and naso-enteral tube removal within one month after surgery.
Nemr
Nair Katia
NK
USP. knemr@uol.com.br
de Carvalho
Marcos Brasilino
MB
Köhle
Juliana
J
Leite
Grazielle Capatto de Almeida
GC
Rapoport
Abrão
A
Szeliga
Regis M Scheffer
RM
D003413:Cricoid Cartilage / Q000601:surgery*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012720:Severity of Illness Index; D013997:Time Factors; D014139:Tracheostomy; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology*