Preliminary Analysis Of The Effects Of Different Types Of Open Partial Laryngectomy On Swallowing Function

Objective:To study the influencing factors of swallowing function in patients with different types of partial laryngectomy and to provide guidance for the recovery of swallowing function.Methods:From September 2017 to December 2020,61 patients with partial laryngectomy were selected,It was divided into three groups,Among them,A group of 12 cases of supraglottic horizontal laryngectomy,B group of 36 cases with vertical partial laryngectomy,C group of 13 cases of total laryngectomy,Using the swallowing questionnaire,Water experiment in the depressions,Evaluation by general examination of electronic nose laryngoscope,Analysis and comparison of each group within 1 month after operation,2-3 months after surgery,The results of swallowing function in 4-6months after operation.Results:Firstly,in 12 patients with upper glottic laryngectomy,One month after surgery,The abnormal swallowing function was 100%(12/12),After 2-3 months,the abnormal swallowing function was 66.67%(8/12),and the abnormal swallowing function was 41.67%(5/12)after four or six months;Secondly,in 36 patients with vertical partial laryngectomy,During three time period,the abnormal swallowing function was72.22%(26/36),33.33%(12/36)and 19.44%(7/36);Among the 13 patients with total laryngectomy,100%(13/13)had abnormal swallowing function at 1 month,61.53%(8/13)at 2-3 months and 46.15%(6/13)at 4-6 months.And then,depending on the location,With the preservation of bilateral arytenoid cartilage,It was divided into reserved epiglottis group and resected epiglottis group,There were 12 cases in the epiglottis group,One month after surgery,100% had abnormal swallowing function(12/12),The abnormal swallowing function was 66.67%(8/12),The abnormal swallowing function was 41.67%(5/12);There were 18 cases in the reserved epiglottis group,The abnormal swallowing function was 66.67%(12/18),33.33%(6/12),Postoperative 4-6 months of anomalies accounted for 22.22 per cent(4/18);The difference of rate between groups was statistically significant.Arytenoid cartilages were resected and arytenoid cartilages were preserved in 36 patients with vertical hemilaryngectomy,Arytenoid cartilage preserved in 14 cases,Abnormalities accounted for 57.14%(8/14),It was 28.57%(4/14)after 2-3 months,21.43%(3/14);In 22 cases,Abnormalities within 1 month after surgery accounted for 81.82%(18/22),36.36%(8/12),4-6 months after surgery,The difference between groups was statistically significant only within 1 month after operation.The vertical half-throat group was divided into the group under 70 years of age and the group over 70 years of age,There were 5 cases in the group over 70 years old.One month after surgery,80%(4/5),Abnormalities accounted for 40%(2/5)within 2-3 months,40% of patients with 4-6 months postoperative abnormalities(2/5);In the group under 70,there were 31 cases,Abnormalities accounted for 70.97%(22/31),32.26%(1%)were abnormal2-3 months after operation(10/31),16.12%(5/31)were found to be abnormal at 4-6months after operation.Conclusion: 1.The incidence of abnormal swallowing was significantly increased by partial laryngectomy and partial laryngectomy.The loss of epiglottis and arytenoid cartilage had an effect on swallowing function,and the loss of epiglottis had a greater effect on swallowing function in the short term after operation.3.age factors also affect postoperative swallowing function recovery.