Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-29T04:14:30.431Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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
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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

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

References

Jemal, A, Siegel, R, Ward, E, Murray, T, Xu, J, Thun, MJ. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43–66CrossRefGoogle ScholarPubMed
Blanchard, P, Baujat, B, Holostenco, V, Bourredjem, A, Baey, C, Bourhis, J et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): a comprehensive analysis by tumour site. Radiother Oncol 2011;100:33–40CrossRefGoogle ScholarPubMed
Bourhis, J, Overgaard, J, Audry, H, Ang, KK, Saunders, M, Bernier, J et al. Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 2006;368:843–54CrossRefGoogle ScholarPubMed
Machtay, M, Moughan, J, Trotti, A, Garden, AS, Weber, RS, Cooper, JS et al. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol 2008;26:3582–9CrossRefGoogle ScholarPubMed
Dowthwaite, SA, Franklin, JH, Palma, DA, Fung, K, Yoo, J, Nichols, AC. The role of transoral robotic surgery in the management of oropharyngeal cancer: a review of the literature. ISRN Oncol 2012;2012:945162Google ScholarPubMed
Weinstein, GS, O'Malley, BW Jr, Hockstein, NG. Transoral robotic surgery: supraglottic laryngectomy in a canine model. Laryngoscope 2005;115:1315–19CrossRefGoogle Scholar
Genden, EM, Desai, S, Sung, CK. Transoral robotic surgery for the management of head and neck cancer: a preliminary experience. Head Neck 2009;31:283–9CrossRefGoogle ScholarPubMed
Weinstein, GS, O'Malley, BW Jr, Cohen, MA, Quon, H. Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2010;136:1079–85CrossRefGoogle ScholarPubMed
Dodds, WJ, Stewart, ET, Logemann, JA. Physiology and radiology of the normal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol 1990;154:953–63CrossRefGoogle ScholarPubMed
Rubesin, SE. Oral and pharyngeal dysphagia. Gastroenterol Clin North Am 1995;24:331–52CrossRefGoogle ScholarPubMed
Kelly, AM, Drinnan, MJ, Leslie, P. Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope 2007;117:1723–7CrossRefGoogle ScholarPubMed
Stoeckli, SJ, Huisman, TA, Seifert, B, Martin-Harris, BJ. Interrater reliability of videofluoroscopic swallow evaluation. Dysphagia 2003;18:53–7CrossRefGoogle ScholarPubMed
Clouse, RE, Staiano, A. Topography of the esophageal peristaltic pressure wave. Am J Physiol 1991;261(4 Pt 1):G677–84Google ScholarPubMed
Takasaki, K, Umeki, H, Enatsu, K, Tanaka, F, Sakihama, N, Kumagami, H et al. Investigation of pharyngeal swallowing function using high-resolution manometry. Laryngoscope 2008;118:1729–32CrossRefGoogle ScholarPubMed
Sobin, LH. TNM classification: clarification of number of regional lymph nodes for pN0. Br J Cancer 2001;85:780Google ScholarPubMed
Fujiwara, K, Fukuhara, T, Kitano, H, Fujii, T, Koyama, S, Yamasaki, A et al. Preliminary study of transoral robotic surgery for pharyngeal cancer in Japan. J Robot Surg 2016;10:11–17CrossRefGoogle ScholarPubMed
Tomifuji, M, Araki, K, Yamashita, T, Shiotani, A. Transoral videolaryngoscopic surgery for oropharyngeal, hypopharyngeal, and supraglottic cancer. Eur Arch Otorhinolaryngol 2014;271:589–97CrossRefGoogle ScholarPubMed
Rosenbek, JC, Robbins, JA, Roecker, EB, Coyle, JL, Wood, JL. A penetration-aspiration scale. Dysphagia 1996;11:93–8CrossRefGoogle ScholarPubMed
Tomifuji, M, Araki, K, Yamashita, T, Mizokami, D, Kamide, D, Suzuki, H et al. Risk factors for dysphagia after transoral videolaryngoscopic surgery for laryngeal and pharyngeal cancer. Head Neck 2016;38:196–201CrossRefGoogle ScholarPubMed
Rich, JT, Liu, J, Haughey, BH. Swallowing function after transoral laser microsurgery (TLM) +/- adjuvant therapy for advanced-stage oropharyngeal cancer. Laryngoscope 2011;121:2381–90CrossRefGoogle ScholarPubMed
Genden, EM, Park, R, Smith, C, Kotz, T. The role of reconstruction for transoral robotic pharyngectomy and concomitant neck dissection. Arch Otolaryngol Head Neck Surg 2011;137:151–6CrossRefGoogle ScholarPubMed
Hurtuk, A, Agrawal, A, Old, M, Teknos, TN, Ozer, E. Outcomes of transoral robotic surgery: a preliminary clinical experience. Otolaryngol Head Neck Surg 2011;145:248–53CrossRefGoogle ScholarPubMed
Iseli, TA, Kulbersh, BD, Iseli, CE, Carroll, WR, Rosenthal, EL, Magnuson, JS. Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg 2009;141:166–71CrossRefGoogle ScholarPubMed
Leonhardt, FD, Quon, H, Abrahao, M, O'Malley, BW Jr, Weinstein, GS. Transoral robotic surgery for oropharyngeal carcinoma and its impact on patient-reported quality of life and function. Head Neck 2012;34:146–54CrossRefGoogle ScholarPubMed
Moore, EJ, Olsen, KD, Kasperbauer, JL. Transoral robotic surgery for oropharyngeal squamous cell carcinoma: a prospective study of feasibility and functional outcomes. Laryngoscope 2009;119:2156–64CrossRefGoogle ScholarPubMed
Moore, EJ, Olsen, SM, Laborde, RR, Garcia, JJ, Walsh, FJ, Price, DL et al. Long-term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc 2012;87:219–25CrossRefGoogle ScholarPubMed
Sinclair, CF, McColloch, NL, Carroll, WR, Rosenthal, EL, Desmond, RA, Magnuson, JS. Patient-perceived and objective functional outcomes following transoral robotic surgery for early oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 2011;137:1112–16CrossRefGoogle ScholarPubMed
Van Abel, KM, Moore, EJ, Carlson, ML, Davidson, JA, Garcia, JJ, Olsen, SM et al. Transoral robotic surgery using the thulium:YAG laser: a prospective study. Arch Otolaryngol Head Neck Surg 2012;138:158–66CrossRefGoogle ScholarPubMed
Weinstein, GS, O'Malley, BW Jr, Snyder, W, Sherman, E, Quon, H. Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 2007;133:1220–6CrossRefGoogle ScholarPubMed
Weinstein, GS, Quon, H, Newman, HJ, Chalian, JA, Malloy, K, Lin, A et al. Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control. Arch Otolaryngol Head Neck Surg 2012;138:628–34Google ScholarPubMed