Physiopathology of dysphagia in older patients following partial laryngectomy due to supraglottic cancer

Paweł Stręk

Vol 4, No 4 (2005): Polish Palliative Medicine

Case reports

Published online: 2006-01-02

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Physiopathology of dysphagia in older patients following partial laryngectomy due to supraglottic cancer

Paweł Stręk

Advances in Palliative Medicine 2005;4(4):156-161.

Vol 4, No 4 (2005): Polish Palliative Medicine

Case reports

Published online: 2006-01-02

Abstract

The incidence of cancer is reported to increase with advancing age. Partial laryngectomy reduced the indications for selected advanced endolaryngeal carcinoma and resulted in higher local control and long-term laryngeal preservation rates. Aspiration is the major problem in deglutition associated with conservation laryngeal surgery. Closure of the glottic sphincter, depression of the epiglottis over the laryngeal inlet, elevation of the thyrohyoid complex under cover of the base of the tongue and appropriate relaxation of the cricopharyngeal muscle to permit unobstructed passage of food into the esophagus are important mechanisms that prevent food from entering the trachea. Oropharyngeal dysphagia in the elderly is the specific result of pathologic condition or illness that may occur more commonly in elderly persons. An increased extent of hyoid displacement in older patients with dysphagia may represent a necessary compensation designed to minimize the effect of the short duration of hyoid elevation on the upper esophageal sphincter opening. Intensive postoperative management appeared to play a key role in the successful functional outcome after partial laryngectomy in the elderly patient.