Management of Oropharyngeal Dysphagia in Laryngeal and Hypopharyngeal Cancer
Figure 6
Case report 2. Male, 64. T2 bilateral glottic epidermoid carcinoma affecting the right laryngeal ventricle and with limited extension to the subglottis. He received a supracricoid laryngectomy with cricohyoidopexy and bilateral functional neck dissection. The sequence of postoperative videofluoroscopic examinations is presented. (a) Early postoperative (10 days) with noticeable aspiration (a3). The patient received a temporary gastrostomy and was instructed in swallowing maneuvers (chin-chest, supraglottic swallow, effortful swallow, and repeated swallow), and was advised to do exercises with honey-pudding consistency. (b) In a 3-month videofluoroscopic control there is penetration (b1) with residue in the laryngeal vestibule (b2) that is cleared by voluntary coughing and repeated swallow (b3). (c) Three months postop: the larynx and the trachea are free of alimentary contents. Note the typical cricopharyngeal bar (c2). Deglutition is effective and safe (c3).
