Total laryngectomy (TL) is the surgical treatment option for advanced stage of laryngeal cancer, involving the removal of larynx along with several muscles attached to it. Several anatomical changes occur following the surgery which will in turn affect the swallowing mechanism. The severing of the cricopharyngeus muscle, which is an important muscle of the pharyngoesophageal segment (PES), may lead to dysphagia. Several other causes have also been explained in the literature. Several invasive instruments have been used to identify dysphagia in this population. The present study aimed to identify the differences in the biomechanics of the PES during dry and wet swallow tasks in persons with TL with and without dysphagia. Amplitude and duration of movement of PES was analysed using a non-invasive instrumental method surface electromyography. The results indicate that amplitude of PES movement was significantly higher in dysphagic group for solids and semisolids. A significantly longer duration was observed for solid consistency for dysphagic group when compared to non-dysphagic group. sEMG evidences suggestive of differences in amplitude and duration between the TL with and without dysphagia groups. Findings also revealed that TL with dysphagia group require more effort to swallow solids and semisolid consistencies when compared to the effort exerted by them during liquid and dry swallow.
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Our sincere thanks to NITTE Institute of Speech and Hearing, Mangalore, Karnataka and HCG Hospital, Bangalore for their support.
Conflicts of interest
The authors declare that they do not have any conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Ethical Committee of Kasturba Hospital, Manipal (IEC No. 260/2018). The study was registered with Clinical Trials Registry of India (CTRI/2018/08/021018).
A language-specific informed consent was taken from all participants prior to the procedure.
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Harsha Raj, G., Aithal, V.U. & Guddattu, V. Comparison of Pharyngoesophageal Segment Biomechanics Between Persons with Total Laryngectomy With and Without Dysphagia Using sEMG: A Multicentric Swallow Study. Dysphagia 35, 843–852 (2020). https://doi.org/10.1007/s00455-020-10090-6
- Surface electromyography
- Total laryngectomy
- Deglutition problems
- Pharyngoesophageal segment