Respiratory-Swallow Pattern Following Total Laryngectomy.

Only 12 adults were studied, and 69 of 92 recorded swallows were analyzed. Many solid-bolus attempts were discarded: 19 of 48 attempts, leaving 29 solid swallows for analysis compared with 40 thin-liquid swallows. Submental surface EMG may be less reliable in a surgically reconstructed population, and no masseter electrode was used to separate swallowing from chewing. Respiratory phase was not corroborated with abdominal or chest wall measures. The TEP and non-TEP groups were unbalanced, with 66% presenting with TEP, so the comparison may be biased. Participants were recruited from speech-language pathology and head and neck cancer clinics, which may have favored recruitment of people with TEP. People with solid-food dysphagia or a modified-consistency diet were excluded, so findings may not apply to laryngectomy patients who already have swallowing difficulty. Bolus volumes were self-selected and may have been larger than in earlier studies, which can affect respiratory-swallow pattern variability.

All authors declared no conflicts of interest. The publication types list NIH extramural research support.

Do not read the inspiration-swallow-inspiration pattern as proof of aspiration risk or unsafe swallowing. This study had 12 adults after total laryngectomy, and the paper states that surgical separation of the airway and esophagus prohibits aspiration.