Special Topics: Dysphagia Care in Laryngectomy Patients
Effects of different surgical treatment on swallowing function in partial laryngectomy patients
Gui Yihua, Zhou Yan, Chen Fangfang, Wu Zhenhua, Huang Qi, Wang Lianchun
Published 2020-02-26
Cite as Chin J Mod Nurs, 2020, 26(6): 717-720. DOI: 10.3760/cma.j.issn.1674-2907.2020.06.004
Abstract
ObjectiveTo explore the effects of different surgical treatments on swallowing function in partial laryngectomy patients and to analyze the development trend of swallowing function.
MethodsFrom January 2019 to September 2019, this study selected 54 patients first diagnosed as laryngeal carcinoma with partial laryngectomy at a ClassⅢ Grade A hospital as subjects by convenience sampling. There were 25 patients with vertical partial laryngectomy (vertical group) , 12 patients with horizontal supra-glottic partial laryngectomy (horizontal group) and 17 patients with supra-cricoid partial laryngectomy (SCPL group) . This study observed the time of gastric tube extubation of patients, video-fluoroscopic swallowing study (VFSS) 15 days after surgery, score of Modified Penetration Aspiration Scale (MPAS) and scores of Gugging Swallowing Screen (GUSS) 15, 20 and 30 days after surgery, and compared the swallowing function of patients among three groups.
ResultsThere were statistical differences in the time of gastric tube extubation, scores of GUSS and VFSS+MPAS 15 days after surgery among three groups (P<0.01) . When taking time as main effect, the Roy maximum root test displayedF=460.693, P<0.001 which showed that time had influence on the score of GUSS; when taking surgery as the main effect, the Roy maximum root test displayedF=218.387, P<0.001 which showed that surgery type had influence on the score of GUSS. There were statistical differences in the development trends of swallowing at different times among three surgery types when time interacted with the surgery type (F=164.033, P<0.001) .
ConclusionsThe vertical partial laryngectomy has the small impact on swallowing function and patients recovery quickly. However, horizontal supra-glottic partial laryngectomy and SCPL have great impact on swallowing function; swallowing function can't be well compensated by sphincter function of remnant larynx in a short time; besides, patients with horizontal supra-glottic partial laryngectomy need a long rehabilitation period.
Key words:
Laryngeal neoplasms; Partial laryngectomy; Deglutition disorders
Contributor Information
Gui Yihua
Surgery of Otolaryngology and Head &
Neck, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
Zhou Yan
Surgery of Otolaryngology and Head &
Neck, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
Chen Fangfang
Nursing Department, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
Wu Zhenhua
Surgery of Otolaryngology and Head &
Neck, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
Huang Qi
Surgery of Otolaryngology and Head &
Neck, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
Wang Lianchun
Surgery of Otolaryngology and Head &
Neck, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China
