Scintigraphic assessment of swallowing after horizontal supraglottic laryngectomy

Objective: Oral-pharyngo-esophageal scintigraphy (OPES) proved to be able t o demonstrate the pharyngeal residue of the radioactive bolus after degluti tion and the presence and amount of tracheobronchial aspiration, and to cal culate exactly the transit time of the various swallowing phases. The aim o f this study was to evaluate the real objective effectiveness of OPES in or der to assess the degree of swallowing recovery after horizontal supraglott ic laryngectomy (HSL). Methods: Nineteen patients entered the study, and 17 healthy subjects were included as control group (group 1). Nineteen patients in whom HSL had been performed at least 1 year before underwent OPES. They were divided into tw o groups: 13 patients (group 2) in whom the tracheal cannula had been remov ed and swallowing, phonatory, and respiratory functions were satisfactory a nd 6 patients (group 3) in whom the tracheostomy tube was still in situ for e aspiration of liquids and scarring of the laryngeal vestibule. Results: Our results showed that in the patients who underwent HSL, all scr intigraphic semiquantitative parameters and particularly aspiration percent age values and Pharyngeal Ritention Index (PRI) at 10 and 60 seconds were a ble to pinpoint some residual "subclinical" alteration and/or minimal surgi cal sequelae frequently observed after this kind of functional surgery, amo unts in group 3 were markedly higher than those in group 2 (p < .0002), and mean PRI values at 10 and 60 second were significantly different (p < .000 1) from normal mean control values (group 1). Conclusion: Oral-pharyngo-esophageal scintigraphy may be regarded as a noni nvasive, well-tolerated technique, with a radiation body burden within sati sfactory limits of radioprotection. It appeared to be also sensitive in ass essing the swallowing recovery after HSL.