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Evaluation of pharyngeal swallowing pressure using high-resolution manometry during transoral surgery for oropharyngeal cancer

Published online by Cambridge University Press:  08 February 2021

K Fujiwara ,
S Koyama ,
K Taira ,
K Kawamoto ,
T Fukuhara  and
H Takeuchi
K Fujiwara*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
S Koyama
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
K Taira
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
K Kawamoto
Affiliation:
Department of Head, Neck, and Thyroid Surgery Center and Otorhinolaryngology, Kusatsu General Hospital, Japan
T Fukuhara
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
H Takeuchi
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
*
Author for correspondence: Dr Kazunori Fujiwara, Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, 683-8504, Japan E-mail: kfujiwa@med.tottori-u.ac.jp Fax: +81 859 38 6629
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Abstract

Background

Transoral robotic surgery is frequently described, driven by the desire to offer a less morbid alternative to chemoradiation. However, the objective evaluation of post-operative function has rarely been reported. Therefore, high-resolution manometry was used in this study to evaluate the impact of changes in peri-operative swallowing function on pharyngeal pressure events.

Methods

Ten patients with various stages of oropharyngeal cancer underwent transoral surgery. High-resolution manometry and videofluoroscopic swallow studies were performed before surgery and two months afterwards. The following parameters were obtained: velopharyngeal and mesopharyngeal post-deglutitive upper oesophageal sphincter pressures, velo-meso-hypopharyngeal contractile integral, upper oesophageal sphincter relaxation pressure, and pharyngeal velocity.

Results

There was no significant difference in pharyngeal pressure or contractile integral pre- versus post-operatively. However, pharyngeal velocity was significantly higher post-operatively than pre-operatively.

Conclusion

High-resolution manometry showed that transoral surgery in patients without pre-operative dysphagia preserved pharyngeal constriction. However, transoral surgery might produce scar formation in the pharynx, which could lead to narrowing of the pharynx.

Keywords

ManometryOropharyngeal CancerTransoral SurgeryDysphagiaSwallowing

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 2 , February 2021 , pp. 153 - 158
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr K Fujiwara takes responsibility for the integrity of the content of the paper

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