Laryngeal Function Following Vertical Partial Laryngectomy

Abstract

The laryngeal function was evaluated in 14 patients following frontlateral laryngectomy and in 2 patients after hemilaryngectomy. The patients were all male, aged 48 to 80 years. A set of phonatory function tests were conducted for each patient. The swallowing function was investigated with the use of a cinefluorography. Vertical movements of the larynx during deglutition and the swallowing pressure were also examined. After frontolateral laryngectomy, the muscle flap employed for glottic reconstruction became atrophic in many cases. It seemed to be difficult to keep the glottis in an adequate size consistently. Phonatory function tests revealed an incomplete glottal closure manifested by a large DC flow and small AC/DC ratio. In a perceptual evaluation, however, the voice was fairly good.
Cinefluorographic study frequently showed an asymmetrical barium passage in the pharynx, piece meal deglutition, aspiration into the trachea, and intrapharyngeal stasis. An abnormal elevation of the swallowing pressure in the hypopharynx was demonstrated in five cases. The results indicate, unexpectedly, that frontolateral laryngectomy can often cause aspiration.
The two patients following hemilaryngectomy had a relatively good voice and no aspiration. The swallowing pressure at the level of the hypopharynx was reduced. They were, however, not able to breathe through the larynx. They had to have a permanent tracheostoma for respiration.