Dysphagia in Open Partial Horizontal Laryngectomy Type IIa: Quantitative Analysis of Videofluoroscopy using the ASPEKT Method.
Raphaela da Costa Miranda Barbosa, Andressa Silva de Freitas, Rayane Beltrão Alves Cerqueira and 3 others
PMID 38431893WHAT IT FOUND
Ten patients after partial laryngectomy showed poor pharyngeal constriction and heavy residue in the pyriform sinuses, despite prolonged airway closure acting as a compensation.
This highlights specific efficiency deficits for targeted therapy rather than general weakness.
Key findings
01Patients showed significantly increased odds of atypical values including prolonged hyoid-burst-to-UES-opening interval, reduced pharyngeal area at rest, and residue in the pyriform sinuses.
02Large effect sizes were found for poor pharyngeal constriction and prolonged time-to-laryngeal vestibule closure, with medium-to-large effect sizes for residue in all locations.
03Redundant tissue protruding into the lumen at the level of the upper esophageal sphincter was observed in 6 of the 10 participants.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (10 patients), limiting generalizability. The study was cross-sectional, capturing a single time-point 11-23 months post-surgery, so it does not show the trajectory of recovery. Participants had variable prior treatments, including radiotherapy and chemotherapy, which could confound swallowing function. Only one thin liquid bolus was analyzed per patient, ignoring within-participant variability and fatigue effects. The use of a cued-swallow technique may have altered swallowing reaction times compared to natural eating.
Declared interests
The authors have no conflicts of interest to disclose.
The easy way to misread this
Do not interpret the presence of compensatory mechanisms, such as prolonged airway closure, as evidence that swallowing function is normal or that no therapy is needed. These are adaptations to significant underlying impairments in pharyngeal constriction and residue clearance.