CHANGE IN RESPIRATORY FUNCTION BEFORE AND AFTER LARYNGECTOMY
Many patients with head and neck cancer have a smoking history, and pulmonary complications frequently lead to post-operative death. Due to technical problems, spirometric pulmonary function tests are rarely performed in patients with laryngectomy. The purpose of this study is to evaluate respirator...
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Published in | Nippon Jibi Inkoka Gakkai Kaiho Vol. 98; no. 7; pp. 1097 - 1103,1251 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
The Oto-Rhino-Laryngological Society of Japan, Inc
1995
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Online Access | Get full text |
ISSN | 0030-6622 1883-0854 |
DOI | 10.3950/jibiinkoka.98.1097 |
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Abstract | Many patients with head and neck cancer have a smoking history, and pulmonary complications frequently lead to post-operative death. Due to technical problems, spirometric pulmonary function tests are rarely performed in patients with laryngectomy. The purpose of this study is to evaluate respiratory function in patients with laryngectomy. We made a tracheal mask with a heat and moisture exchanging baseholder, and used it for spirometry. Eight patients with laryngectomy, including 5 with laryngeal cancer and 3 with hypopharyngeal cancer, were studied. Arterial blood gas analysis and pulmonary function measurements, such as VC, % VC, FEV1.0% and V25/height (V25/HT), were evaluated before and after laryngectomy. Statistical analysis of the data was performed with the Wilcoxon rank-sum test. The following results were obtained: 1) No statistically significant changes in arterial blood gases and FEV1.0% were found. 2) A statistically significant decrease in VC was found after total laryngectomy (p<0.05). 3) A statistically significant decreas in V25/HT, which reflects small air way closure of the lung, was observed after total laryngectomy (p<0.05). In all cases, the V25/HT value was below normal limits. We concluded that the decrease in VC was caused by a decrease in dead space in the upper airway, and that V25/HT may be a good parameter for evaluation of pulmonary function after laryngectomy. |
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AbstractList | Many patients with head and neck cancer have a smoking history, and pulmonary complications frequently lead to post-operative death. Due to technical problems, spirometric pulmonary function tests are rarely performed in patients with laryngectomy. The purpose of this study is to evaluate respiratory function in patients with laryngectomy. We made a tracheal mask with a heat and moisture exchanging baseholder, and used it for spirometry. Eight patients with laryngectomy, including 5 with laryngeal cancer and 3 with hypopharyngeal cancer, were studied. Arterial blood gas analysis and pulmonary function measurements, such as VC, % VC, FEV1.0% and V25/height (V25/HT), were evaluated before and after laryngectomy. Statistical analysis of the data was performed with the Wilcoxon rank-sum test. The following results were obtained: 1) No statistically significant changes in arterial blood gases and FEV1.0% were found. 2) A statistically significant decrease in VC was found after total laryngectomy (p<0.05). 3) A statistically significant decreas in V25/HT, which reflects small air way closure of the lung, was observed after total laryngectomy (p<0.05). In all cases, the V25/HT value was below normal limits. We concluded that the decrease in VC was caused by a decrease in dead space in the upper airway, and that V25/HT may be a good parameter for evaluation of pulmonary function after laryngectomy. |
Author | YOSHIZUMI, TAKASHI EBIHARA, SATOSHI SHIZUKA, TAKAO HAYASHI, RYUICHI UCHIYAMA, KIYOTAKA MATSUURA, KAZUTO ASAI, MASAO |
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References | 14) Savard P, Cole P, Miljeteig H,: Laryngeal resistance to respiratory airflow in humans. Laryngoscope 103: 785-792, 1993. 5) 福永武之. 浅野庄三, 野坂保次: 喉摘者の換気機能. 気食会報26: 10-14, 1975. 3) Torjussen W: Airway obstructions in laryngectomized patients. Acta Otolaryngologica 66: 161-170. 1968. 6) Natvig K: Influence of different climates on the peak expiratory flow in laryngectomees. J laryngol Otol 98: 53-58, 1984. 10) 辺土名仁. 石川紀彦, 竹生田勝次: 喉頭摘出者の術前. 術後の呼吸機能について. 日耳鼻91: 56-64, 1988. 11) 川口雄才: 食道癌手術における術後肺合併症の予測-術前肺機能評価を中心として-. 日外会誌91: 1667-1674, 1990. 8) 江口実美, 福崎隆: 気管呼吸患者 (受喉剔者) の呼吸機能検査成績について. 日耳鼻69: 48-52, 1966. 1) Todisco T, Maurizi M, Paludetti G,: Longterm follow-up of respiratory functions after laryngectomy. Respiration 45: 303-315, 1984. 4) Usui N: Ventilatory function in laryngectomized patients. Auris-Nasus-Larynx (Tokyo) 6: 87-96, 1979. 9) Ackerstaff AH. Souren T. Zandwijk N,: Improvements in the assessment of pulmonary function in laryngectomized patients. Laryngoscope 103: 1391-1394. 1993. 13) 福地義之助: 気流閉塞 (air flow limitation) とはなにか. 日常臨床のための気管支喘息と閉塞性肺疾患. 原沢道美編, 現代医療社: 14-21頁, 1992. 7) Harris S. Jonson B: Lung function before and after laryngectomy. Acta Otolaryng 78: 287-294, 1974. 12) 浦田誓夫訳: 換気力学 (メカニクス). 肺機能検査マニュアル. Ruppel G著, 医歯薬出版: 31-50頁, 1990. 2) Togawa K, Konno A, Hoshino T: A physiologic study on respiratory handicap of the laryngectomised. Arch Otorhinolaryngol 229: 69-79, 1980. |
References_xml | – reference: 13) 福地義之助: 気流閉塞 (air flow limitation) とはなにか. 日常臨床のための気管支喘息と閉塞性肺疾患. 原沢道美編, 現代医療社: 14-21頁, 1992. – reference: 11) 川口雄才: 食道癌手術における術後肺合併症の予測-術前肺機能評価を中心として-. 日外会誌91: 1667-1674, 1990. – reference: 14) Savard P, Cole P, Miljeteig H,: Laryngeal resistance to respiratory airflow in humans. Laryngoscope 103: 785-792, 1993. – reference: 6) Natvig K: Influence of different climates on the peak expiratory flow in laryngectomees. J laryngol Otol 98: 53-58, 1984. – reference: 4) Usui N: Ventilatory function in laryngectomized patients. Auris-Nasus-Larynx (Tokyo) 6: 87-96, 1979. – reference: 12) 浦田誓夫訳: 換気力学 (メカニクス). 肺機能検査マニュアル. Ruppel G著, 医歯薬出版: 31-50頁, 1990. – reference: 7) Harris S. Jonson B: Lung function before and after laryngectomy. Acta Otolaryng 78: 287-294, 1974. – reference: 8) 江口実美, 福崎隆: 気管呼吸患者 (受喉剔者) の呼吸機能検査成績について. 日耳鼻69: 48-52, 1966. – reference: 1) Todisco T, Maurizi M, Paludetti G,: Longterm follow-up of respiratory functions after laryngectomy. Respiration 45: 303-315, 1984. – reference: 5) 福永武之. 浅野庄三, 野坂保次: 喉摘者の換気機能. 気食会報26: 10-14, 1975. – reference: 10) 辺土名仁. 石川紀彦, 竹生田勝次: 喉頭摘出者の術前. 術後の呼吸機能について. 日耳鼻91: 56-64, 1988. – reference: 3) Torjussen W: Airway obstructions in laryngectomized patients. Acta Otolaryngologica 66: 161-170. 1968. – reference: 2) Togawa K, Konno A, Hoshino T: A physiologic study on respiratory handicap of the laryngectomised. Arch Otorhinolaryngol 229: 69-79, 1980. – reference: 9) Ackerstaff AH. Souren T. Zandwijk N,: Improvements in the assessment of pulmonary function in laryngectomized patients. Laryngoscope 103: 1391-1394. 1993. |
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