Evaluación funcional de deglución-aspiración en pacientes sometidos a laringectomía subtotal supracricoidea con cricohioidoepiglotopexia
2018
Introduction: Supracricoid subtotal laryngectomy associated with cricohyoidoepiglottopexy is the most efficient conservative
surgical technique to preserve laryngeal functions in patients with locally advanced carcinoma of the larynx. The most feared
complication of this intervention is aspiration at the moment of swallowing and secondary pneumonia; there are several ways
to evaluate aspiration and its degree. We present a novel form to identify even small amounts of tracheobronchial aspiration.
Method: Patients undergoing subtotal laryngectomy and cricohyoidoepiglottopexy due to laryngeal cancer were included; all
of them were postoperatively assessed with radioactive-swallow. Based on the symptoms and the scintigraphy result, prolonging
the feeding time by nasogastric tube was decided. Results: Thirty-seven patients were included; 4 of them had received
radiotherapy; aspiration rate was 29.7 %; 50 % of patients who had received radiation had aspiration; 18 % of subjects with
tracheobronchial aspiration required prolongation of feeding time by nasogastric tube, none required total laryngectomy for
aspiration that hindered swallowing. Conclusions: Postoperative evaluation of patients undergoing subtotal laryngectomy with
radioactive-swallow, allows to identify even minimal amounts of fluid aspirated into the bronchial tree and to plan the moment
for swallowing to be started.
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