2020 Volume 11 Issue 2 Pages 81-89
Objective: Dysphagia occurring after surgery to treat thoracic esophageal cancer is commonly believed to be caused by recurrent laryngeal nerve (RLN) paralysis and injury to the muscles involved in swallowing due to manipulation during cervical lymph node dissection. However, we previously performed studies in our department and reported that RLN paralysis and dysphagia are not necessarily related. We also found that geniohyoid muscle atrophy, which occurs due to perioperative fasting, may also cause dysphagia. Meanwhile, some reports have documented a relationship between dysphagia and decreased laryngeal elevation distance (LED) during videofluorography (VF) in elderly patients and after esophageal cancer surgery. There are few published reports of a relationship between dysphagia and changes in the LED that have compared pre- and postoperative VF findings. We therefore performed a study of the relationship between the incidence of dysphagia and changes in pre- and postoperative LED.
Method and Results: The subjects of the present study were 72 patients who underwent surgery to treat thoracic esophageal cancer in our department from April 2014 to March 2020. All patients underwent pre- and postoperative VF, during which we measured the LED. We divided them into an aspiration (A) group of 17 patients and a non-aspiration (NA) group of 55 patients. The difference between the pre- and postoperative LED values was 14.12 ± 5.67 mm in the A group, which was significantly larger than the NA group value (8.63 ± 4.83 mm, P = 0.0002). The rate of change in the LED was significantly greater in the A group at 45.72 ± 15.69%, compared with 31.69 ± 14.67% in the NA group (P = 0.0011).
Conclusion: There was a significant decrease in LED among patients presenting with postoperative dysphagia after esophageal cancer surgery, suggesting that LED measurement may be a useful quantitative indicator assessable during VF.
