Browse > Article

Surgical Strategies for Prevention and Treatment of Airway Aspiration in Head and Neck Cancer Patients  

Baek, Min Kwan (Department of Otolaryngology-Head & Neck Surgery, Gachon University School of Medicine, Gil Medical Center)
Kim, Dong Young (Department of Otolaryngology-Head & Neck Surgery, Gachon University School of Medicine, Gil Medical Center)
Publication Information
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics / v.29, no.1, 2018 , pp. 9-13 More about this Journal
Abstract
Postoperative airway aspiration is not uncommon in patients with head and neck cancer. Airway aspiration has serious consequences, such as swallowing disorders, nutrition-related health problem, or reducing the quality of life due to maintenance of tracheal or nasogastric tubes. The postoperative oropharyngeal defect due to the surgery may interfere with normal swallowing reflex, or the laryngeal dysfunction caused by radiation therapy may cause severe airway aspiration, which may lead to complications such as dyspnea and pneumonia. Complete removal of the disease is also important in the treatment of head and neck cancer, but it is necessary to select a method to avoid and predict the occurrence of airway aspiration according to the treatment method. The most important factor to prevent airway aspiration after surgery is to preserve the proper volume of the oropharynx and to preserve at least one of the cricoarytenoid joint function. It is also the most effective way to reduce additional complications by seeking appropriate surgical treatment according to airway aspiration status. The purpose of this study is to review the operative methods that can induce airway aspiration and consider the prevention and treatment strategy through review of the literature.
Keywords
Aspiration; Prevention; Treatment; Head and neck neoplasms;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Price LH, Li Y, Patel A, Gyawali CP. Reproducibility patterns of multiple rapid swallows during high resolution esophageal manometry provide insights into esophageal pathophysiology. Neurogastroenterol Motil 2014;26(5):646-53.   DOI
2 Newman R, Vilardell N, Clave P, Speyer R. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia:White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia 2016;31(2):232-49.   DOI
3 Dalmazo J, Aprile LR, Dantas RO. Esophageal Transit, Contraction and Perception of Transit After Swallows of Two Viscous Boluses. Gastroenterology Res 2015;8(5):274-8.   DOI
4 Lang IM, Medda BK, Jadcherla SR, Shaker R. Characterization and mechanisms of the pharyngeal swallow activated by stimulation of the esophagus. Am J Physiol Gastrointest Liver Physiol 2016;311(5):G827-G37.   DOI
5 Murphy BA, Gilbert J. Dysphagia in head and neck cancer patients treated with radiation: assessment, sequelae, and rehabilitation. Semin Radiat Oncol 2009;19(1):35-42.   DOI
6 Montgomery WW. Surgery to prevent aspiration. Arch Otolaryngol 1975;101(11):679-82.   DOI
7 Habal MB, Murray JE. Surgical treatment of life-endangering chronic aspiration pneumonia. Use of an epiglottic flap to the arytenoids. Plast Reconstr Surg 1972;49(3):305-11.   DOI
8 Vecchione TR, Habal MB, Murray JE. Further experiences with the arytenoid-epiglottic flap for chronic aspiration pneumonia. Plast Reconstr Surg 1975;55(3):318-23.   DOI
9 Weisberger EC, Huebsch SA. Endoscopic treatment of aspiration using a laryngeal stent. Otolaryngol Head Neck Surg 1982;90(2):215-22.   DOI
10 Smith JE, Suh JD, Erman A, Nabili V, Chhetri DK, Blackwell KE. Risk factors predicting aspiration after free flap reconstruction of oral cavity and oropharyngeal defects. Arch Otolaryngol Head Neck Surg 2008;134(11):1205-8.   DOI
11 Politi M, Costa F, Robiony M, Rinaldo A, Ferlito A. Review of segmental and marginal resection of the mandible in patients with oral cancer. Acta Otolaryngol 2000;120(5):569-79.   DOI
12 Schrag C, Chang YM, Tsai CY, Wei FC. Complete rehabilitation of the mandible following segmental resection. J Surg Oncol 2006;94 (6):538-45.   DOI
13 Zacharek MA, Pasha R, Meleca RJ, Dworkin JP, Stachler RJ, Jacobs JR, et al. Functional outcomes after supracricoid laryngectomy. Laryngoscope 2001;111(9):1558-64.   DOI
14 Gooris PJ, Worthington P, Evans JR. Mandibulotomy: a surgical approach to oral and pharyngeal lesions. Int J Oral Maxillofac Surg 1989;18(6):359-64.   DOI
15 Fujimoto Y, Hasegawa Y, Nakayama B, Matsuura H. Usefulness and limitation of crico-pharyngeal myotomy and laryngeal suspension after wide resection of the tongue or oropharynx. Nihon Jibiinkoka Gakkai Kaiho 1998;101(3):307-11.   DOI
16 Krappen S, Remmert S, Gehrking E, Zwaan M. Cinematographic functional diagnosis of swallowing after plastic reconstruction of large tumor defects of the mouth cavity and pharynx. Laryngorhinootologie 1997;76(4):229-34.   DOI
17 Spriano G, Pellini R, Romano G, Muscatello L, Roselli R. Supracricoid partial laryngectomy as salvage surgery after radiation failure. Head Neck 2002;24(8):759-65.   DOI
18 Blitzer A. Evaluation and management of chronic aspiration. N Y State J Med 1987;87(3):154-60.
19 Kirchner JC, Sasaki CT. Surgery for aspiration. Otolaryngol Clin North Am 1984;17(1):49-56.
20 Sasaki CT, Milmoe G, Yanagisawa E, Berry K, Kirchner JA. Surgical closure of the larynx for intractable aspiration. Arch Otolaryngol 1980;106(7):422-3.   DOI
21 Wein RO, Weber RS. The current role of vertical partial laryngectomy and open supraglottic laryngectomy. Curr Probl Cancer 2005;29(4):201-14.   DOI
22 Rademaker AW, Logemann JA, Pauloski BR, Bowman JB, Lazarus CL, Sisson GA, et al. Recovery of postoperative swallowing in patients undergoing partial laryngectomy. Head Neck 1993;15(4):325-34.   DOI
23 Konsulov SS. Surgical treatment of anterolateral tongue carcinoma. Folia Med (Plovdiv) 2005;47(3-4):20-3.
24 Prades JM, Simon PG, Timoshenko AP, Dumollard JM, Schmitt T, Martin C. Extended and standard supraglottic laryngectomies:a review of 110 patients. Eur Arch Otorhinolaryngol 2005;262(12):947-52.   DOI
25 Jacob R, Zorowka P, Welkoborsky HJ, Mann WJ. Long-term functional outcome of Laccourreye hemipharyngectomy-hemilaryngectomy with reference to oncologic outcome. Laryngorhinootologie 1998;77(2):93-9.   DOI
26 de Bree R, Reith R, Quak JJ, Uyl-de Groot CA, van Agthoven M, Leemans CR. Free radial forearm flap versus pectoralis major myocutaneous flap reconstruction of oral and oropharyngeal defects:a cost analysis. Clin Otolaryngol 2007;32(4):275-82.   DOI
27 Pauloski BR, Rademaker AW, Logemann JA, McConnel FM, Heiser MA, Cardinale S, et al. Surgical variables affecting swallowing in patients treated for oral/oropharyngeal cancer. Head Neck 2004;26(7):625-36.   DOI
28 Su WF, Hsia YJ, Chang YC, Chen SG, Sheng H. Functional comparison after reconstruction with a radial forearm free flap or a pectoralis major flap for cancer of the tongue. Otolaryngol Head Neck Surg 2003;128(3):412-8.   DOI
29 Zuydam AC, Rogers SN, Brown JS, Vaughan ED, Magennis P. Swallowing rehabilitation after oro-pharyngeal resection for squamous cell carcinoma. Br J Oral Maxillofac Surg 2000;38(5):513-8.   DOI
30 Martini DV, Har-El G, Lucente FE, Slavit DH. Swallowing and pharyngeal function in postoperative pharyngeal cancer patients. Ear Nose Throat J 1997;76(7):450-3, 6.
31 Nicoletti G, Soutar DS, Jackson MS, Wrench AA, Robertson G. Chewing and swallowing after surgical treatment for oral cancer: functional evaluation in 196 selected cases. Plast Reconstr Surg 2004;114(2):329-38.   DOI
32 Schechter GL. Systemic causes of dysphagia in adults. Otolaryngol Clin North Am 1998;31(3):525-35.   DOI
33 Dray TG, Hillel AD, Miller RM. Dysphagia caused by neurologic deficits. Otolaryngol Clin North Am 1998;31(3):507-24.   DOI
34 Burnip E, Owen SJ, Barker S, Patterson JM. Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer. J Laryngol Otol 2013;127(11):1116-21.   DOI
35 Bulow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in patients with pharyngeal dysfunction. Dysphagia 2001;16(3):190-5.   DOI
36 Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Effects of postural change on aspiration in head and neck surgical patients. Otolaryngol Head Neck Surg 1994;110(2):222-7.   DOI
37 Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 1993;74(7):736-9.   DOI
38 Cameron JL, Zuidema GD. Aspiration pneumonia. Magnitude and frequency of the problem. JAMA 1972;219(9):1194-6.   DOI
39 Cavalot AL, Ricci E, Schindler A, Roggero N, Albera R, Utari C, et al. The importance of preoperative swallowing therapy in subtotal laryngectomies. Otolaryngol Head Neck Surg 2009;140(6):822-5.   DOI
40 Lin Z, Yim B, Gawron A, Imam H, Kahrilas PJ, Pandolfino JE. The four phases of esophageal bolus transit defined by high-resolution impedance manometry and fluoroscopy. Am J Physiol Gastrointest Liver Physiol 2014;307(4):G437-44.   DOI
41 Lazarus C, Logemann JA, Song CW, Rademaker AW, Kahrilas PJ. Effects of voluntary maneuvers on tongue base function for swallowing. Folia Phoniatr Logop 2002;54(4):171-6.   DOI
42 Kilic C, Tuncel U, Kaya M, Comert E, Ozlugedik S. Swallowing and Aspiration: How Much Is Affected by the Number of Arytenoid Cartilages Remaining After Supracricoid Partial Laryngectomy? Clin Exp Otorhinolaryngol 2016;10(4):344-8.   DOI
43 Liu B, Pan Z, Ji W, Wang J. Study of reserving unilateral arytenoid cartilage to improve voice quality in supracricoid partial laryngectomy with anastomosis of cricoid cartilage, base of tongue and epiglottis. Lin Chuang Er Bi Yan Hou Ke Za Zhi 2005;19(21):961-3.
44 Kruse-Losler B, Langer E, Reich A, Joos U, Kleinheinz J. Score system for elective tracheotomy in major head and neck tumour surgery. Acta Anaesthesiol Scand 2005;49(5):654-9.   DOI
45 Kaatzke-McDonald MN, Post E, Davis PJ. The effects of cold, touch, and chemical stimulation of the anterior faucial pillar on human swallowing. Dysphagia 1996;11(3):198-206.   DOI
46 Denk DM, Swoboda H, Schima W, Eibenberger K. Prognostic factors for swallowing rehabilitation following head and neck cancer surgery. Acta Otolaryngol 1997;117(5):769-74.   DOI
47 Lazarus CL. Effects of radiation therapy and voluntary maneuvers on swallow functioning in head and neck cancer patients. Clin Commun Disord 1993;3(4):11-20.
48 Breunig C, Benter P, Seidl RO, Coordes A. Predictable swallowing function after open horizontal supraglottic partial laryngectomy. Auris Nasus Larynx 2016;43(6):658-65.   DOI
49 Bhattacharyya N, Kotz T, Shapiro J. Dysphagia and aspiration with unilateral vocal cord immobility: incidence, characterization, and response to surgical treatment. Ann Otol Rhinol Laryngol 2002;111(8):672-9.   DOI
50 Giraldez-Rodriguez LA, Johns M, 3rd. Glottal insufficiency with aspiration risk in dysphagia. Otolaryngol Clin North Am 2013;46(6):1113-21.   DOI