Assessment and management of dysphagia following pharyngolaryngectomy with free jejunal interposition: A series of eight case studies

Ward, EC, Frisby, J and O'Connor, D (2001) Assessment and management of dysphagia following pharyngolaryngectomy with free jejunal interposition: A series of eight case studies. Journal of Medical Speech-language Pathology, 9 1: 89-105.

Author Ward, EC
Frisby, J
O'Connor, D
Title Assessment and management of dysphagia following pharyngolaryngectomy with free jejunal interposition: A series of eight case studies
Journal name Journal of Medical Speech-language Pathology   Check publisher's open access policy
ISSN 1065-1438
Publication date 2001
Sub-type Article (original research)
Volume 9
Issue 1
Start page 89
End page 105
Total pages 17
Editor Leonard L Lapointe
Place of publication United States
Publisher Singular Publishers
Collection year 2001
Language eng
Subject C1
321025 Rehabilitation and Therapy - Hearing and Speech
730303 Occupational, speech and physiotherapy
Abstract The physiological and structural deficits contributing to swallowing complications in the pharyngolaryngectomy patient population are not homogeneous. Consequently, a team approach, involving medical investigations as well as clinical and radiological assessments of swallowing, is necessary to facilitate diagnosis of the underlying impairment and assist the medical/surgical and speech pathology team members in the process of individualizing the management plan for each patient. In the present study, the clinical assessment and management of eight pharyngolaryngectomy patients who presented with a decline in swallowing function unrelated to immediate postsurgical effects or direct effects of radiotherapy are reported. Clinical and radiological investigations revealed a heterogeneous group of factors contributing to their swallowing impairments and disability levels, including difficulty with graft and anastomotic patency and graft motility, impaired lingual coordination, increased bolus transit time, nasal and oral regurgitation, patient distress, and recurrence. Variation between the cases supported the need for differential intervention and management plans for all eight patients. Ratings of perceived swallowing disability, handicap, and well-being/distress levels at initial assessment and again six months following dysphagia intervention revealed a pattern of reduced levels of impairment, functional disability, and overall patient distress levels following informed intervention. The present case study data highlights the key role thorough clinical and radiological investigations play in the process of diagnosing the factors contributing to dysphagia and guiding the management of the resultant swallowing disability in the pharyngolaryngectomy population.
Keyword Clinical Neurology
Cervical Esophagus
Reconstruction
Hypopharynx
Graft
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 0 times in Thomson Reuters Web of Science Article
Google Scholar Search Google Scholar
Access Statistics: 266 Abstract Views  -  Detailed Statistics
Created: Tue, 14 Aug 2007, 16:04:25 EST