Total Larenjektomili Bireylerde Yutmanın Kinematik Özelliklerini Etkileyen Faktörlerin Araştırılması
Özet
Dysphagia is a common problem after
total laryngectomy (TL). The primary aim of this study is to investigate the changes in
swallowing biomechanics after TL via kinematic analysis and to determine the factors
affecting swallowing. A total of 34 subjects with TL were included in the study. After
clinical swallowing examination, kinematic parameters including pharyngeal transit
duration (PTD), maximum pharyngeal constriction ratio (MPCR), upper esophageal
sphincter opening ratio (UESOR), upper esophageal sphincter opening duration
(UESOD), and bolus clearance ratio (BCR) were investigated from Videofluoroscopic
Swallowing Study (VFSS) records via Image J software. Symptomatic swallowing
complaints were determined in 47.1% of the subjects (n=16). PTD, MPCR, and BCR
parameters were found significantly higher in subjects with symptomatic swallowing
complaints compared to those without. Significant correlations were found between age
and PTD and also between the time after chemoradiotherapy and BCR. Subjects who
communicate by writing and/or using sign language had higher value of BCR than those
who use other communication methods. Compared to the subjects receiving other
treatments, those receiving both chemotherapy and radiotherapy had significantly lower
UESOR but significantly longer UESOD. There was no relationship between kinematic
parameters and the surgical features including the type of incision, presence of neck
dissection, presence and type of thyroidectomy, type of reconstruction, and type of
mucosal closure. When feature studies confirm the current findings, it will be useful to
include kinematic analysis in the swallowing assessment battery of individuals with TL.