Respiratory-Swallow Pattern Following Total Laryngectomy

Fullerton, Amy; Mou, Yuhan; Silver, Natalie L.; Chheda, Neil N.; Bolser, Donald C.; Wheeler-Hegland, Karen

doi:10.1007/s00455-019-10031-y

Cited by 4 publications

(5 citation statements)

References 35 publications

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“…Altered swallow apnea duration has been reported in stroke, neurodegenerative disease, chronic obstructive pulmonary disease (COPD), cerebral palsy, and aging 28–31 . While data have not yet been published on apnea duration in HNC relative to healthy norms, the majority of published data corroborating postswallow inhalation in OP dysphagia—including stroke, COPD, and total laryngectomy—have described a significantly longer swallow apnea duration than in healthy controls 27,28,31 . Similarly, we found that the duration of the apneic period was longer for the subset of CRT rats inhaling after the swallow, compared to both the controls and CRT‐EX groups.…”

Section: Discussionsupporting

confidence: 65%

“…Swallow apnea is an obligatory component of the pharyngeal phase of swallowing, present even in cases of total laryngectomy, 26,27 and is highly conserved across mammalian species 3 . Altered swallow apnea duration has been reported in stroke, neurodegenerative disease, chronic obstructive pulmonary disease (COPD), cerebral palsy, and aging 28–31 .…”

Section: Discussionmentioning

confidence: 99%

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Respiratory‐swallow coordination in a rat model of chemoradiation

2021

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Background Chemoradiation treatment (CRT) for head and neck cancer (HNC) is associated with postswallow inhale events that elevate the risk of penetration/aspiration. The purpose of this study was to assess the validity of a rat model for investigating the effect of CRT on respiratory‐swallow coordination. Methods Videofluoroscopic swallow study was performed on 10 Sprague‐Dawley rats 3 months post‐CRT (3 mg/kg Cisplatin, 10 fractions of 4.5 Gy/day radiotherapy to tongue base), and 10 naïve controls. We examined the effect of CRT on swallow apnea duration, diaphragm movement, and bolus kinematics. Results CRT rats had a significant increase in postswallow inhale (p = 0.008), which was associated with significantly longer swallow apnea durations, lower diaphragm displacement at swallow onset, and faster pharyngoesophageal bolus speed. Conclusion The rat CRT model is valid for the study of respiratory‐swallow coordination due to the consistency of findings in this study with those reported in clinical CRT studies in HNC.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Respiratory‐swallow coordination in a rat model of chemoradiation

2021

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“…[29][30][31] Similarly, laryngectomy greatly impacts breathing, communication, and swallowing function. [32][33][34] The experience and perception of these postoperative changes may serve as a further impetus for litigation. In comparison, there may be less morbidity associated with oncologic resection and reconstruction of cancers involving the lip, tonsil, and other oral cavity cancers.…”

Section: Discussionmentioning

confidence: 99%

“…Glossectomy impacts speech, mastication, swallowing, and may cause aspiration in some cases 29–31 . Similarly, laryngectomy greatly impacts breathing, communication, and swallowing function 32–34 . The experience and perception of these postoperative changes may serve as a further impetus for litigation.…”

Section: Discussionmentioning

confidence: 99%

Delayed in diagnosis of upper aerodigestive tract cancers: A comprehensive review of medical malpractice cases

Fritz

Rajasekaran

2023

Head & Neck

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Background Factors that prompt litigation and influence outcomes for malpractice cases involving cancers of the upper aerodigestive tract are incompletely described. Methods Westlaw, a national legal database, was searched for medical malpractice claims related to upper aerodigestive tract cancer for all years available. Results Of the 122 cases meeting inclusion criteria, 106 (86.9%) involved allegations of failure to diagnose or delay in diagnosis. Tongue, larynx, and nasopharynx cancers were more frequently litigated than would be expected based on their incidence (tongue, 38.7% of aerodigestive tract litigation vs. 26.9% of aerodigestive tract cancers; larynx, 33.0% vs. 22.3%; nasopharynx, 10.4% vs. 4.6%). Payouts were made in over half of diagnosis failure lawsuits (56.6%), which carried an average award of $2840690 [IQR 850219–2537509]. Conclusions An awareness of litigation on cancers of the upper aerodigestive tract holds the potential to improve patient care and help otolaryngologists avoid potential risks for litigation.

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“…Before the start of testing, the skin was shaved if necessary and thoroughly cleaned with alcohol. Surface EMG electrodes (Bagnoli surface electrode, Delsys Incorporated, Natick, MA) were placed bilaterally over the scalene and sternocleidomastoid (SCM) muscles, along with a submental electrode under the chin, 26 to record muscle activity during all PFTs. To establish a stable electric baseline and minimize the effects of external noise and enhance the quality of signal to noise ratio, the EMG signals were differentially amplified (gain: 10 k) and bandpass filtered (20-450 Hz) using a biopotential amplifier (Bagnoli-8, Delsys EMG) before digitization at 4 kHz.…”

Section: Instrumentationmentioning

confidence: 99%

Effect of Test Interface on Respiratory Muscle Activity and Pulmonary Function During Respiratory Testing in Healthy Adults: A Pilot Study

Sajjadi

Mabe

Seven

et al. 2022

Cardiopulm Phys Ther J

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Purpose: The mouthpiece is the standard interface for spirometry tests. Although the use of a mouthpiece can be challenging for patients with orofacial weakness, maintaining a proper seal with a facemask can be an issue for healthy individuals during forceful efforts. We compared respiratory muscle activity and tests using a mouthpiece and facemask in healthy adults to investigate whether they can be used interchangeably. Methods: In this observational study, subjects (n 5 12) completed forced vital capacity, maximal respiratory pressure, and peak cough flow with a mouthpiece and facemask. Root mean square values of the genioglossus, diaphragm, scalene, and sternocleidomastoid were compared between conditions. Results: When switching from a mouthpiece to a facemask, significantly higher values were seen for peak cough flow (average bias 5 254.36 L/min, P , .05) and the difference seen with maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP) were clinically significant (average bias: MEP 5 27.33, MIP 5 25.2). In addition, the submental activity was significantly greater when MIP was conducted with a mouthpiece. No significant differences were seen in respiratory muscle activity during resting breathing or spirometry. Conclusions: There are clinically significant differences with cough and MEP tests, and neck muscles are activated differently based on interface. Considering the small sample size, our findings suggest a facemask may be used to complete some pulmonary function tests.

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Respiratory-Swallow Pattern Following Total Laryngectomy

Cited by 4 publications

References 35 publications

Respiratory‐swallow coordination in a rat model of chemoradiation

Respiratory‐swallow coordination in a rat model of chemoradiation

Delayed in diagnosis of upper aerodigestive tract cancers: A comprehensive review of medical malpractice cases

Effect of Test Interface on Respiratory Muscle Activity and Pulmonary Function During Respiratory Testing in Healthy Adults: A Pilot Study

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