Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia

N. N. Venkatesan, C. M. Johnson, M. T. Siddiqui, D. J. Cates, M. A. Kuhn, G. N. Postma, P. C. Belafsky

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Methods: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre-and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Results: Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra-and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). Conclusion: The ovine model displayed perfect intra-and inter-species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalJournal of Laryngology and Otology
Volume131
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Laryngectomy
Deglutition
Deglutition Disorders
Sheep
Swallows
Cadaver
Suspensions
Safety
Fluoroscopy
National Institutes of Health (U.S.)
Barium
Neck
Head

Keywords

  • Deglutition Disorders
  • Experimental Animal Model
  • Laryngectomy
  • Respiratory Aspiration
  • Surgical Models

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia. / Venkatesan, N. N.; Johnson, C. M.; Siddiqui, M. T.; Cates, D. J.; Kuhn, M. A.; Postma, G. N.; Belafsky, P. C.

In: Journal of Laryngology and Otology, Vol. 131, No. 4, 01.04.2017, p. 350-356.

Research output: Contribution to journalArticle

Venkatesan, N. N. ; Johnson, C. M. ; Siddiqui, M. T. ; Cates, D. J. ; Kuhn, M. A. ; Postma, G. N. ; Belafsky, P. C. / Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia. In: Journal of Laryngology and Otology. 2017 ; Vol. 131, No. 4. pp. 350-356.
@article{16aa8c54e8614be49864fd606f30879a,
title = "Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia",
abstract = "Objectives: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Methods: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre-and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Results: Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra-and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). Conclusion: The ovine model displayed perfect intra-and inter-species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.",
keywords = "Deglutition Disorders, Experimental Animal Model, Laryngectomy, Respiratory Aspiration, Surgical Models",
author = "Venkatesan, {N. N.} and Johnson, {C. M.} and Siddiqui, {M. T.} and Cates, {D. J.} and Kuhn, {M. A.} and Postma, {G. N.} and Belafsky, {P. C.}",
year = "2017",
month = "4",
day = "1",
doi = "10.1017/S0022215117000032",
language = "English (US)",
volume = "131",
pages = "350--356",
journal = "Journal of Laryngology and Otology",
issn = "0022-2151",
publisher = "Cambridge University Press",
number = "4",

}

TY - JOUR

T1 - Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia

AU - Venkatesan, N. N.

AU - Johnson, C. M.

AU - Siddiqui, M. T.

AU - Cates, D. J.

AU - Kuhn, M. A.

AU - Postma, G. N.

AU - Belafsky, P. C.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Objectives: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Methods: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre-and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Results: Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra-and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). Conclusion: The ovine model displayed perfect intra-and inter-species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.

AB - Objectives: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Methods: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre-and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Results: Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra-and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). Conclusion: The ovine model displayed perfect intra-and inter-species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.

KW - Deglutition Disorders

KW - Experimental Animal Model

KW - Laryngectomy

KW - Respiratory Aspiration

KW - Surgical Models

UR - http://www.scopus.com/inward/record.url?scp=85010888078&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85010888078&partnerID=8YFLogxK

U2 - 10.1017/S0022215117000032

DO - 10.1017/S0022215117000032

M3 - Article

C2 - 28124628

AN - SCOPUS:85010888078

VL - 131

SP - 350

EP - 356

JO - Journal of Laryngology and Otology

JF - Journal of Laryngology and Otology

SN - 0022-2151

IS - 4

ER -