SCINTIGRAPHIC ASSESSMENT OF SWALLOW EFFICIENCY POSTLARYNGECTOMY

There have been reports of a high incidence of hypopharyngeal stenosis in total laryngectomy patients when the surgery requires a partial ph aryngectomy for pyriform sinus involvement. In this study, three group s were compared: total laryngectomy patients without partial pharyngec tomy, total laryngectomy patients with partial pharyngectomy, and norm al controls. All patients had received radiation therapy following sur gery. All were maintaining oral nutrition, and none complained of dysp hagia. Patients were tested between 1 and 7 months postradiation thera py, with a mean of 3 months. Measures of swallowing efficiency were ba sed on scintigraphic data for a liquid swallow. Patients with partial pharyngectomy had abnormally long oropharyngeal transit times and low efficiency scores. For a subgroup of patients with partial pharyngecto my, swallowing data were available postsurgery and postradiation thera py Postsurgery this patient group did not differ significantly from no rmal patients in swallowing efficiency, and swallowing efficiency dete riorated in postradiation therapy. This scintigraphic methodology is s hown to be a sensitive method of assessing swallowing function in this patient population.