Original scientific paper
The Role of Videofluoroscopy and Ultrasound in Assessing Pharyngoesophageal Muscle Tone after Laryngectomy
Robert Tićac
; University of Rijeka, Rijeka University Hospital Center, Department of Otorhinolaryngology, Rijeka, Croatia
Barbara Čandrlić
; University of Rijeka, Rijeka University Hospital Center, Department of Radiology, Rijeka, Croatia
Jurica Juranić
; University of Rijeka, Rijeka University Hospital Center, Department of Anesthesiology and Intensive Care Medicine,
Goran Pavelić
; University of Rijeka, Rijeka University Hospital Center, Department of Otorhinolaryngology, Rijeka, Croatia
Dijana Pedisić
; University of Rijeka, Rijeka University Hospital Center, Department of Otorhinolaryngology, Rijeka, Croatia
Marin Pušić
; University of Rijeka, Rijeka University Hospital Center, Department of Radiology, Rijeka, Croatia
Marko Velepič
; University of Rijeka, Rijeka University Hospital Center, Department of Otorhinolaryngology, Rijeka, Croatia
Radan Starčević
; University of Rijeka, Rijeka University Hospital Center, Department of Otorhinolaryngology, Rijeka, Croatia
Damir Miletić
; University of Rijeka, Rijeka University Hospital Center, Department of Radiology, Rijeka, Croatia
Abstract
The aim of this study was to compare the respective value of videofluoroscopy and ultrasound for assessment of the tonicity of the neoglottis and determination of the exact neolaryngeal segment of hypertonicity. We examined twelve patients who had developed inadequate tracheoesophageal voice following total laryngectomy and installation of tracheoesophageal prosthesis. We assumed that the cause of the unsatisfactory voice quality in our patients was neolaryngeal muscle spasm2,12–13. After determining the exact hypertonic segment, we administered lidocaine intramuscularly and
tried to act on the hypertonic segment. By means of ideofluoroscopy as gold standard1,6 for comparison with ultrasound examination, we followed the passage of contrast through the neo-larynx and watched for dilatation of the segment during swallowing, phonation and at rest to determine whether there were any tonus disturbances or differences before and after lidocaine injection. In conclusion, a combination of the two methods could yield better results in voice restoration. Videofluoroscopy is the method of choice for initial assessment and determination of the hypertonic segment, while ultrasound is the method to apply to facilitate administering the drug more precisely.
Keywords
laryngectomy; tracheoesophageal prosthesis; neo-larynx; lidocaine; hypertonic spasm
Hrčak ID:
96484
URI
Publication date:
2.1.2013.
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