ArticleEsophagus : official journal of the Japan Esophageal Society2024
Critical swallowing functions contributing to dysphagia in patients with recurrent laryngeal nerve paralysis after esophagectomy.
Article in Esophagus : official journal of the Japan Esophageal Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 8 citations in OpenAlex.
- Prognostic impact of recurrent laryngeal nerve palsy after esophagectomy: a systematic review and reconstructed individual patient data meta-analysis.Journal of thoracic disease · 2026Article
- Article
- Vagus nerve/recurrent laryngeal nerve ratio: proposal of a new parameter predicting left vocal cord palsy using intraoperative nerve monitoring during esophagectomy.General thoracic and cardiovascular surgery · 2025Article
- Progress on aspiration assessment methods for patients after esophageal cancer surgery in early: A review.Medicine · 2025Review
- Prevention and Management of Recurrent Laryngeal Nerve Palsy in Minimally Invasive Esophagectomy: Current Status and Future Perspectives.Journal of clinical medicine · 2024Review
- Non-invasive vagus nerve magnetic stimulation combined with rehabilitation training for vocal cord paralysis and dysphagia following brain injury: a prospective case series study.Frontiers in neurologyArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRecurrent laryngeal nerve paralysis (RLNP) after esophagectomy can cause aspiration because of incomplete glottis closure, leading to pneumonia. However, patients with RLNP often have preserved swallowing function. This study investigated factors that determine swallowing function in patients with RLNP.
methodsPatients with esophageal cancer who underwent esophagectomy and cervical esophagogastric anastomosis were enrolled between 2017 and 2020. Videofluoroscopic examination of swallowing study (VFSS) and acoustic voice analysis were performed on patients with suspected dysphagia including RLNP. Dysphagia in VFSS was defined as score ≥ 3 of the 8-point penetration-aspiration scale VFSS and acoustic analysis results related to dysphagia were compared between patients with and without RLNP.
resultsAmong 312 patients who underwent esophagectomy, 74 developed RLNP. The incidence of late-onset pneumonia was significantly higher in the RLNP group than in the non-RLNP (18.9 vs. 8.0%, P = .008). Detailed swallowing function was assessed by VFSS in 84 patients, and patients with RLNP and dysphagia showed significantly shorter maximum diagonal hyoid bone elevation (10.62 vs. 16.75 mm; P = .003), which was a specific finding not seen in patients without RLNP. For acoustic voice analysis, the degree of hoarseness was not closely related to dysphagia. The length of oral intake rehabilitation for patients with and without RLNP was comparable if they did not present with dysphagia (8.5 vs. 9.0 days).
conclusionsImpaired hyoid bone elevation is a specific dysphagia factor in patients with RLNP, suggesting compensatory epiglottis inversion by hyoid bone elevation is important for incomplete glottis closure caused by RLNP.
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