Cs. Easterling et al., Pharyngeal dysphagia in postesophagectomy patients: Correlation with deglutitive biomechanics, ANN THORAC, 69(4), 2000, pp. 989-992
Citations number
11
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. Because of the transient nature of pharyngeal phase dysphagia,
posttranshiatal esophagectomy patients provide a model for studying the cor
relation of dysphagic symptoms and aspiration with deglutitive biomechanics
.
Methods. We studied 8 transhiatal esophagectomy patients (age range, 51 to
78 years) and 8 normal age-matched controls in upright position using later
al and anteroposterior (AP) projection videofluoroscopy during three 5 mt b
arium swallows.
Results. The maximum upper esophageal sphincter (UES) AP diameter and maxim
um anterior excursion of the hyoid bone in patients with transhiatal esopha
gectomy who experienced aspiration (6.2 +/- 0.6 and 9.0 +/- 2.0 mm, respect
ively) were significantly smaller than those of age-matched normal controls
(9.4 +/- 0.7 and 17.0 +/- 1.0 mm, respectively). Resolution of aspiration
was associated with a significant increase in AP diameter of the UES as wel
l as anterior and superior excursion of the hyoid bone (p < 0.05).
Conclusions. Dysphagic symptoms and aspiration in posttranshiatal esophagec
tomy patients are associated with significant abnormalities of deglutitive
biomechanics. Improvement in deglutitive biomechanics is associated with re
solution of dysphagic symptoms as well as postdeglutitive aspiration in the
se patients. (C) 2000 by The Society of Thoracic Surgeons.