The use of fiberoptic endoscopically controlled methylene blue swallows inthe diagnosis of postoperative dysphagia and aspiration

Postoperative swallowing disorders are common after such function-preservin g surgery as conventional resections or endoscopic laser procedures for car cinomas of the larynx and hypopharynx. In most cases a reduction in motilit y of the pharyngeal muscles and sensory impairment of the pharyngeal and la ryngeal regions can occur because of postoperative tissue abnormalities, in cluding scarring due to the healing process. We have used fiberoptic endosc opic examinations with methylene blue to analyze postoperative swallowing a nd observe whether staining or aspiration occurs. By so doing, we have impr oved postoperative swallowing in 25 patients after extended surgery for can cer and were able to detect or exclude aspiration. The advantages of this m inimally invasive, non-stressful diagnostic procedure are discussed and can be important for further successful care after surgery.