Total Laryngectomy Essay

Mrs. Newman has been experiencing hoarseness and a change in her voice, but she did not seek medical help until she began to have difficulty swallowing. After being seen by her healthcare provider, she is scheduled for outpatient surgery for a direct laryngoscope to obtain a culture and take a biopsy.

Dysphagia is a disorder that is characterized by difficulty swallowing, causing aspiration which, in result, causes many other life threatening sicknesses. Nearly 15 million adults in the United States are affected by dysphagia. Dysphagia and aspiration may cause complications such as malnutrition, pneumonia, dehydration, pulmonary fibrosis, and even death (Blumenfeld,

Normal respiration consists of inhalation and exhalation. Inhalation is taking in oxygen and delivering it to all cells in the body and exhalation is picking up carbon dioxide waster product of cells and taking it out. Air travel from the nose or mouth into the larynx into the trachea and ends up in the lungs where oxygen is dropped and carbon dioxide is picked up. Oxygen is really important for cell function and when oxygen is not delivered, cells begin to die. So when process of breathing does not work properly other methods of delivering oxygen are used such as tracheostomy.

In the first category of dysphagia, “individual have a decreased ability to accomplish the initial steps of swallowing in an orderly sequence” (Copstead & Banasik, 2013, p. 721). The normal process of swallowing starts with the contraction of pharynx, which then leads to the closure of the epiglottis and results in the relaxation of the upper esophageal sphincter (Copstead and Banasik, 2013). After the relaxation of the upper esophageal sphincter, there is an “initiation of peristalsis by contraction of the striated muscle in the upper portion of the esophagus is altered, or the certain steps in the sequence may be absent” (Copstead & Banasik, 2013, p. 721).

A Summary of Dysphagia: Warning Signs and Management Dysphagia is a condition of weakened or damaged muscles and nerves that are utilized during the swallowing process, leaving a patient unable to properly swallow food, drinks, and medications. This disorder, which can be caused by many different disease processes, can cause a serious problem known as aspiration. The prevalence of this disorder varies due to the etiology of a disease process but it is projected to affect fifty to seventy-five percent of nursing home inhabitants and roughly eight percent worldwide.

You may be surprised how many times you swallow throughout the day -- every time you eat or drink something, you have to swallow multiple times. You also swallow salvia throughout the day. The condition where one has difficulty swallowing is referred to as dysphagia or the swallowing disorder. Use this guide to better understand what your loved one is going through, and how a qualified speech pathologist can assist them.

Introduction Background and Significance Dysphagia is a swallowing disorder that is described as an abnormality in transferring a solid or liquid bolus from the oral cavity to the stomach (Bernard, Loeslie, & Rabatin, 2015). With a diagnosis of dysphagia, a patient will likely aspirate foods and/or liquids of different consistencies. Aspiration is “the entry of food or liquid into the airway below the true vocal folds” (Logemann, 1998, p. 5). Specifically, thin liquid dysphagia occurs when a patient aspirates while consuming any liquids that are not thickened, such as water. Patients with thin-liquid dysphagia are often prescribed a modified thickened liquid-only diet, meaning they consume liquids that are thickened to a greater consistency of nectar, honey, or pudding (Carlaw et al., 2007). An increased viscosity reduces the flow rate of a bolus, makes it more cohesive, and is easier for many people to control intraorally, thus preventing spillage into the airway (Murray, Miller, Doeltgen, & Scholten, 2013). Dysphagia can also contribute to the occurrence of aspiration pneumonia. Aspiration pneumonia occurs “when organisms infiltrate the lower respiratory tract during an episode of aspiration and the

Kulbersh, B. D., Rosenthal, E. L., McGrew, B. M., Duncan, R. D., McColloch, N. L., Carroll, W. R., & Magnuson, J. S. (2006). Pretreatment, preoperative swallowing exercises may improve dysphagia quality of life. The Laryngoscope, 116(6), 883-886. Research Question (PICO) P: patients with head and neck cancer I: pretreatment swallowing exercises

A description of the probable etiologies (causes) of the condition: A laryngectomy is usually the result of treatment for laryngeal cancer. This operation is the removal of the larynx, either a full or partial removal. It is typically performed because of the presence cancerous tissue or tumors. A laryngectomy is usually only implemented after all other treatment options have been exhausted. A total laryngectomy is typically done when the cancer is advanced. There have been rare cases where the reason of a laryngectomy was caused by a wound from a gunshot, auto accident injuries, accidents from violence or other damages to the larynx.

Throat cancer is defined as a disease where malignant cells form in the tissues of the pharynx. Throat cancer is also known as pharyngeal cancer. There are different sections that can be affected by throat cancer; these sections include laryngeal, nasopharyngeal, oropharyngeal, hypopharyngeal, and glottis cancer. Some of the signs and symptoms of this disease include ear pain, sore throat, frequent headaches, and trouble breathing or speaking. If a person has

Tracheoesophageal Speech: o According to the American Speech-Lanugage-Hearing Association (ASHA), a prosthesis is inserted between the trachea and esophagus (2004a). It allows air from the lungs enter the esophagus, causing it to vibrate

Patients and methods This study was a retrospective comparative trial, included 43 adult patients of both genders, requiring tracheotomy, selected from ICUs in darelshefa and RICU Ainshams University hospitals.

An orofacial examination testing sensation, range of motion, and strength revealed mandibular and buccal function be within normal limits, right-tongue weakness and fasciculation’s Diadochokinetic rate or of labial movement and respiratory rate was within normal limits. Dentition intact with ample occlusion. Palatine tonsils and anterior faucial pillars were normal in

In addition, micrognathia causes the proportionally large tongue to be displaced posteriorly in the oropharynx, increasing the difficulty to adequately view the vocal cords with DL (Heinrich, Birkholz, Ihmsen, Irouschek, Ackermann, & Schmidt, 2012). An update of the American Society of Anesthesiologists (ASA) difficult airway algorithm was most recently published in 2013 in Anesthesiology. The algorithm outlines the steps to be taken when an anesthetist encounters a patient with a difficult airway (Apfelbaum, Hagberg, Caplan, et al., 2013). Preparation for a difficult airway includes a thorough evaluation, availability of difficult airway equipment, assigning assistance with the patient, informing the patient (or guardian) of the difficult airway possibility, preoxygenation prior to airway manipulation, and administering supplemental O2 throughout the airway management (Apfelbaum, Hagberg, Caplan, et

Pathophysiology “Achalasia comes from the Greek word khalasiswhich means “not relaxing” (Pandolfino and Gawron, 2015).Indications of achalasia include the “absence of oesophageal peristalsis and the incomplete relaxation of the Lower Esophageal Sphincter (LES) during which swallowing is difficult”(Steffens, Oumer, and Roberts, 2013). According to Izbicki, et al (2009), patients exhibit vomiting and weight loss as the disease progresses as LES does not relax with swallowing but carries on squeezing the end of the ooesophagus. A barrier is formed which stops the solids and the liquids from going to the stomach thereby accumulating volumes of such intake and eventually dilating the oesophagus further.The symptomatic result of the disorder is dysphagia which can progress to other symptoms, such