De Vincentiis M I, Calcagno P, Di Cello P, Mastronicola R, Simonelli M, Ruoppolo G, Cerro P, Gallo A
Audiology and Phoniatrics "G. Ferreri", University of Rome "La Sapienza", Department of Otorhinolaryngology, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy.
Rev Laryngol Otol Rhinol (Bord). 2004;125(4):223-7.
The aim of subtotal laryngeal surgery (Cricohyoidopexy = CHP and Cricohyoidoepiglottopexy = CHEP) is to create a simplified but functional neolarynx. The neolarynx permits the passage of air, the closure of the airway, and ensures phonation through the vibration of the cricoid and arytenoid mucosa; furthermore, it allows the recovery of swallowing, optimizing the closure of the neoglottis with the movement of the remaining arytenoids. The aim of the present study was to evaluate, on a long-term basis, the efficiency of the swallowing function comparing swallowing times in CHEP and CHP with and without functional neck dissection (FND).
A radiological study was conducted on 48 patients selected from a group of 253, who underwent subtotal laryngectomies at the "G. Ferreri" Department of Otorhinolaryngology, Audiology and Phoniatrics of the University of Rome "La Sapienza". The selection of the 48 patients was carried out based on the following criteria: type of surgery, date of surgery (follow up of at least 12 months), patients who were not treated with radiotherapy before or after surgery, patients who were also examined with fibrolaryngoscopy and videofluoroscopy, patients not affected by motor deficits involving phonatory and swallowing regions (stroke, lesions of the central nervous system), negative follow up (no evidence of disease). The parameters for evaluating the functional recovery were the times the nasogastric tube and tracheotomy tube were kept in place. The functional recovery times of the groups thus formed were compared to one another Through videofluoroscopy the authors evaluated oral transit times (OTT) and pharyngeal transit times (PTT) as parameters of deglutition.
The results consistently showed that swallowing time remains under one second as in individuals with normal swallowing functions.
The study of deglutition times, conducted at least 12 months after surgery, does not show any substantial differences between CHEP and CHP with reference to pharyngeal transit and oral transit times.
喉次全切除术（环状舌骨固定术=CHP和环状舌骨会厌固定术=CHEP）的目的是创建一个简化但功能正常的新喉。新喉允许空气通过、气道关闭，并通过环状软骨和杓状软骨黏膜的振动确保发声；此外，它还能恢复吞咽功能，通过剩余杓状软骨的运动优化新声门的关闭。本研究的目的是长期评估吞咽功能的效率，比较有和没有功能性颈清扫术（FND）的CHEP和CHP患者的吞咽时间。
对从253例患者中选出的48例患者进行了放射学研究，这些患者在罗马“La Sapienza”大学“G. Ferreri”耳鼻咽喉科、听力学和语音学系接受了喉次全切除术。根据以下标准选择这48例患者：手术类型、手术日期（至少随访12个月）、手术前后未接受放疗的患者、接受纤维喉镜检查和视频透视检查的患者、未受涉及发声和吞咽区域运动功能障碍（中风、中枢神经系统病变）影响的患者、随访结果为阴性（无疾病证据）。评估功能恢复的参数是鼻胃管和气管切开管留置的时间。通过视频透视检查，作者评估了口腔通过时间（OTT）和咽部通过时间（PTT）作为吞咽参数。将由此形成的各组功能恢复时间进行相互比较。
结果一致表明，吞咽时间与吞咽功能正常的个体一样保持在1秒以内。
在手术后至少12个月进行的吞咽时间研究表明，CHEP和CHP在咽部通过时间和口腔通过时间方面没有任何实质性差异。
