후두전적출술후 식도기능의 변화

Abstract

The total laryngectomy completely interrupts the continuity of the proximal digestive tube and may lead to derangement in esophageal motility. The purpose of present investigation was to observe the effect of total laryngectomy on the motility of the esophagus and its sphincters. In as attempt to explain postoperative dysphagia, stational pull-through method of manometric evaluations were used to quantify the motility change. The study was performed on a group of forteen patients with total laryngectomy and tweleve peoples without esophageal disease or symptoms as controls. There was a statistically significant difference between the control group and the laryngectomy group for the resting and constraction pressures as for the coordination and relaxation of the upper esophageal sphincter. In patients' group, 3 of them who complained dysphagia showed much decreased motility of upper esophageal sphincter than others, but 4 of them showed nearly normal sphincter function. The esophageal body wave pressure and in percentage of normal esophageal peristaltic waves were significantly decreased in patients' group. NO significant difference between controls and laryngectomees were noted in the resting and postdeglution lower esophageal sphincter pressure, nor in the degree of lower esophageal sphincter coordination and relaxation From these results, interruption of cricopharyngeal muscle and vagal interruption after laryngectomy may not only produce local derangement in upper esophageal sphincter function but may also produce abnormalities in esophageal peristalsis.