Archives of otolaryngology--head & neck surgery · 2003
Evaluation of the effects of primary myotomy in total laryngectomy on the neoglottis with the use of quantitative videofluoroscopy.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Op de Coul Bas M R, van den Hoogen Frank J A, van As Corina J, Marres Henri A M, Joosten Frank B M, Manni Johannes J, Hilgers Frans J M
Аннотация
OBJECTIVE: To evaluate the influence of primary myotomy on characteristics of the neoglottis in patients after laryngectomy.
DESIGN: Patient survey.
SETTING: University Medical Center St Radboud, Nijmegen, the Netherlands.
PATIENTS: Nineteen consecutive patients who underwent laryngectomy (12 with primary lateral myotomy of the upper esophageal sphincter [marked by metal clips]; 7 not requiring myotomy [according to intraoperative palpation]).
INTERVENTIONS: Videofluoroscopy.
MAIN OUTCOME MEASURES: Visual assessments and quantitative measures of the neoglottis were used to study the relationships between myotomy, and anatomic and morphologic characteristics of the neoglottis.
RESULTS: Quantitative measurements showed no difference between the neoglottic characteristics of the patients with (n = 12) and without (n = 7) myotomy, who were all judged to have moderate (n = 4) or good (n = 15) voice quality. Results for the entire patient group during phonation showed only 1 single neoglottic bar, no hypertonicity of the neoglottis, and a significant shortening of the neoglottic bar (P =.007). Results for the myotomy group during phonation showed elevation of the caudal clip (P =.046), shortening of the myotomy (P =.01), and decreased overlap of the cranial clip and the neoglottic bar (P =.007). Furthermore, significant relationships were found between the various quantitative measures of the neoglottis and those of the myotomy.
CONCLUSIONS: Quantitative videofluoroscopy enables study of the influence of myotomy on the anatomic and morphologic characteristics of the neoglottis. Our results suggest that a planned myotomy of the upper esophageal sphincter is beneficial when prosthetic voice rehabilitation is applied after total laryngectomy.
DESIGN: Patient survey.
SETTING: University Medical Center St Radboud, Nijmegen, the Netherlands.
PATIENTS: Nineteen consecutive patients who underwent laryngectomy (12 with primary lateral myotomy of the upper esophageal sphincter [marked by metal clips]; 7 not requiring myotomy [according to intraoperative palpation]).
INTERVENTIONS: Videofluoroscopy.
MAIN OUTCOME MEASURES: Visual assessments and quantitative measures of the neoglottis were used to study the relationships between myotomy, and anatomic and morphologic characteristics of the neoglottis.
RESULTS: Quantitative measurements showed no difference between the neoglottic characteristics of the patients with (n = 12) and without (n = 7) myotomy, who were all judged to have moderate (n = 4) or good (n = 15) voice quality. Results for the entire patient group during phonation showed only 1 single neoglottic bar, no hypertonicity of the neoglottis, and a significant shortening of the neoglottic bar (P =.007). Results for the myotomy group during phonation showed elevation of the caudal clip (P =.046), shortening of the myotomy (P =.01), and decreased overlap of the cranial clip and the neoglottic bar (P =.007). Furthermore, significant relationships were found between the various quantitative measures of the neoglottis and those of the myotomy.
CONCLUSIONS: Quantitative videofluoroscopy enables study of the influence of myotomy on the anatomic and morphologic characteristics of the neoglottis. Our results suggest that a planned myotomy of the upper esophageal sphincter is beneficial when prosthetic voice rehabilitation is applied after total laryngectomy.