Background and Objectives: Supracricoid partial larngectomy (SCPL) has showed good function and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to
a
wide
resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postoperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and
simultanously
provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL patients.
Materials and Methods: We reviewed the medical records of the 52 patients who received SCPL for laryneal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them, 21 patients were
performed
MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one
eliminating
the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) group, they were received the traditional rehabilitation training with a supraglottic swallow.
Results: The mean postoperative day (POD) of decannulation was earlier in MBS(+) group (12.6±4.7 POD) than in MBS(-) group (19.5±11.0 POD) (p=0.012), especially in patients showing aspiration (MBS(+) : 12.9±5.2 POD, MBS(-) : 22.3±9.9
POD
(p=0.008). No significant differencee was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was
not
statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12 cases) than in MBS(-) (7/12 cases).
Conclusions: In SCPL patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.
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