Swallowing disorder following salvage total pharyngo-laryngo-esophagectomy with free jejunum reconstruction

Maruo,Takashi; Sakuraba,Minoru; Shinozaki,Takeshi; Tomioka,Toshifumi; Okano,Wataru; Arahira,Satoko; Iino,Yoshie; Hayashi,Ryuichi

doi:10.3892/ol.2018.8213

Swallowing disorder following salvage total pharyngo-laryngo-esophagectomy with free jejunum reconstruction

Authors:
- Takashi Maruo
- Minoru Sakuraba
- Takeshi Shinozaki
- Toshifumi Tomioka
- Wataru Okano
- Satoko Arahira
- Yoshie Iino
- Ryuichi Hayashi
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Affiliations: Department of Otorhinolaryngology, Nagoya University, Nagoya, Aichi 466‑8550, Japan, Department of Plastic Surgery, Iwate Medical School, Morioka, Iwate 020‑8505, Japan, Department of Head and Neck Surgery, National Cancer Research Center Hospital East, Kashiwa, Chiba 277‑0882, Japan, Department of Radiation Oncology, National Cancer Research Center Hospital East, Kashiwa, Chiba 277‑0882, Japan, Department of Rehabilitation, National Cancer Research Center Hospital East, Kashiwa, Chiba 277‑0882, Japan
Published online on: March 8, 2018 https://doi.org/10.3892/ol.2018.8213
Pages: 7355-7361

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Abstract

For recurrent cases or residual cases following concomitant chemo‑radiation therapy (CCRT), salvage surgery is a frequently used treatment options. A swallowing disorder is one of the major complications of CCRT. The purpose of the present study was to evaluate the effect of CCRT on swallowing function in patients who underwent salvage total pharyngo-laryngo-esophagectomy (TPLE), and to evaluate the importance of pharyngeal constriction in patients who underwent TPLE. Between 2008 January and 2014 May, 54 patients were treated with salvage TPLE following CCRT or TPLE at the National Cancer Center Hospital East, Chiba, Japan and were included in the present study. A total of 14 patients underwent salvage TPLE following CCRT for recurrence or residual tumor (the salvage TPLE group), and 40 patients underwent TPLE as initial treatment (the TPLE group). The pharyngeal constriction score and the post‑swallowing oropharyngeal residue rate were evaluated, and inadequate velopharyngeal closure was assessed by videofluorography. The pharyngeal constriction score of the salvage TPLE group was poorer than that of the TPLE group (P<0.05). The bolus residue in the oropharynx was significantly larger in the salvage TPLE group than in the TPLE group (P<0.05). With regards to inadequate velopharyngeal closure, there was no significant difference between the TPLE group and the salvage TPLE group (P>0.99). The results of the present study indicate that the swallowing function of patients who undergo salvage TPLE may be affected by CCRT.

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1	Adelstein DJ, Li Y, Adams GL, Wagner H Jr, Kish JA, Ensley JF, Schuller DE and Forastiere AA: An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol. 21:92–98. 2003. View Article : Google Scholar : PubMed/NCBI
2	Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, Glisson B, Trotti A, Ridge JA, Chao C, et al: Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 349:2091–2098. 2003. View Article : Google Scholar : PubMed/NCBI
3	Lee SC, Shores CG and Weissler MC: Salvage surgery after failed primary concomitant chemoradiation. Curr Opin Otolaryngol Head Neck Surg. 16:135–140. 2008. View Article : Google Scholar : PubMed/NCBI
4	Esteller E, Vega MC, López M, Quer M and León X: Salvage surgery after locoregional failure in head and neck carcinoma patients treated with chemoradiotherapy. Eur Arch Otorhinolaryngol. 268:295–301. 2011. View Article : Google Scholar : PubMed/NCBI
5	Richey LM, Shores CG, George J, Lee S, Couch MJ, Sutton DK and Weissler MC: The effectiveness of salvage surgery after the failure of primary concomitant chemoradiation in head and neck cancer. Otolaryngol Head Neck Surg. 136:98–103. 2007. View Article : Google Scholar : PubMed/NCBI
6	Weber RS, Berkey BA, Forastiere A, Cooper J, Maor M, Goepfert H, Morrison W, Glisson B, Trotti A, Ridge JA, et al: Outcome of salvage total laryngectomy following organ preservation therapy: The Radiation Therapy Oncology Group trial 91-11. Arch Otolaryngol Head Neck Surg. 129:44–49. 2003. View Article : Google Scholar : PubMed/NCBI
7	Ozawa K, Fujimoto Y and Nakashima T: Changes in laryngeal sensation evaluated with a new method before and after radiotherapy. Eur Arch Otorhinolaryngol. 267:811–816. 2010. View Article : Google Scholar : PubMed/NCBI
8	van der Molen L, van Rossum MA, Ackerstaff AH, Smeele LE, Rasch CR and Hilgers FJ: Pretreatment organ function in patients with advanced head and neck cancer: Clinical outcome measures and patients' views. BMC Ear Nose Throat Disord. 9:102009. View Article : Google Scholar : PubMed/NCBI
9	Crary MA and Glowasky AL: Using botulinum toxin A to improve speech and swallowing function following total laryngectomy. Arch Otolaryngol Head Neck Surg. 122:760–763. 1996. View Article : Google Scholar : PubMed/NCBI
10	Torres WE, Fibus TF, Coleman JJ III, Clements JL Jr and Bernardino ME: Radiographic evaluation of the free jejunal graft. Gastrointest Radiol. 12:226–230. 1987. View Article : Google Scholar : PubMed/NCBI
11	Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL and Trotti A: AJCC cancer staging manual. 7th edition. New York, NY: Springer; 2010
12	Gambee LP: A single-layer open intestinal anastomosis applicable to the small as well as the large intestine. West J Surg Obstet Gynecol. 59:1–5. 1951.PubMed/NCBI
13	Sarukawa S, Sakuraba M, Kimata Y, Yasumura T, Uchiyama K, Hishinuma S, Nakatsuka T, Hayashi R, Ebihara S and Harii K: Standardization of free jejunum transfer after total pharyngolaryngoesophagectomy. Laryngoscope. 116:976–981. 2006. View Article : Google Scholar : PubMed/NCBI
14	Ueda K, Okada N, Kitazumi H, et al: VF evaluation criteria of the Japanese Society of Dysphagia Rehabilitation. Jap J Dysphagia Rehabil. 15:76–95. 2011.
15	Dejaeger E, Pelemans W, Ponette E and Joosten E: Mechanisms involved in postdeglutition retention in the elderly. Dysphagia. 12:63–67. 1997. View Article : Google Scholar : PubMed/NCBI
16	Kendall KA and Leonard RJ: Pharyngeal constriction in elderly dysphagic patients compared with young and elderly nondysphagic controls. Dysphagia. 16:272–278. 2001. View Article : Google Scholar : PubMed/NCBI
17	Leonard R, Belafsky PC and Rees CJ: Relationship between fluoroscopic and manometric measures of pharyngeal constriction: The pharyngeal constriction ratio. Ann Otol Rhinol Laryngol. 115:897–901. 2006. View Article : Google Scholar : PubMed/NCBI
18	Leonard R, Rees CJ, Belafsky P and Allen J: Fluoroscopic surrogate for pharyngeal strength: The pharyngeal constriction ratio (PCR). Dysphagia. 26:13–17. 2011. View Article : Google Scholar : PubMed/NCBI
19	Yip H, Leonard R and Belafsky PC: Can a fluoroscopic estimation of pharyngeal constriction predict aspiration? Otolaryngol Head Neck Surg. 135:215–217. 2006. View Article : Google Scholar : PubMed/NCBI
20	Lan Y, Xu G, Dou Z, Lin T, Yu F and Jiang L: The correlation between manometric and videofluoroscopic measurements of the swallowing function in brainstem stroke patients with Dysphagia. J Clin Gastroenterol. 49:24–30. 2015. View Article : Google Scholar : PubMed/NCBI
21	Rademaker AW, Pauloski BR, Logemann JA and Shanahan TK: Oropharyngeal swallow efficiency as a representative measure of swallowing function. J Speech Hear Res. 37:314–325. 1994. View Article : Google Scholar : PubMed/NCBI
22	Ward EC, Bishop B, Frisby J and Stevens M: Swallowing outcomes following laryngectomy and pharyngolaryngectomy. Arch Otolaryngol Head Neck Surg. 128:181–186. 2002. View Article : Google Scholar : PubMed/NCBI
23	Eisbruch A, Kim HM, Feng FY, Lyden TH, Haxer MJ, Feng M, Worden FP, Bradford CR, Prince ME, Moyer JS, et al: Chemo-IMRT of oropharyngeal cancer aiming to reduce dysphagia: Swallowing organs late complication probabilities and dosimetric correlates. Int J Radiat Oncol Biol Phys. 81:e93–e99. 2011. View Article : Google Scholar : PubMed/NCBI
24	Stokely SL, Peladeau-Pigeon M, Leigh C, Molfenter SM and Steele CM: The relationship between pharyngeal constriction and Post-swallow residue. Dysphagia. 30:349–356. 2015. View Article : Google Scholar : PubMed/NCBI
25	Logemann JA: Treatment of oral and pharyngeal dysphagia. Phys Med Rehabil Clin N Am. 19(803–816): ix2008.