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. 2012 Dec;78(6):51-5.
doi: 10.5935/1808-8694.20120033.

Evolution of swallowing in lateral pharyngoplasty with stylopharyngeal muscle preservation

Jayson Junior Mesti  1 , Michel Burihan Cahali
Affiliations

Evolution of swallowing in lateral pharyngoplasty with stylopharyngeal muscle preservation

Jayson Junior Mesti et al. Braz J Otorhinolaryngol. 2012 Dec.

Abstract

Lateral pharyngoplasty manages obstructive sleep apnea through the myotomy and repositioning of the muscles of the lateral pharyngeal wall. Dysphagia after any pharyngeal surgery is influenced by pain, discomfort from the sutures, the healing process and by the adaptation to the changes in pharyngeal structures. Experience with lateral pharyngoplasty has shown that the superior pharyngeal constrictor muscle plays a minor role in swallowing. One of them, the stylopharyngeus muscle, seems to play an important role during swallowing.

Objective: The aim of this study is to provide a daily analysis of the follow-up of the swallowing function.

Method: We have prospectively evaluated the swallowing function in 20 patients, through the daily application of a visual analogue scale from the first post-op until the complete disappearance of dysphagia.

Results: Patients have returned to their normal feeding habits in a mean of 10.9 days after the procedures and they presented a completely normal swallowing, on average, 21.6 days after the surgeries. All patients recover normal swallowing after the procedures, with a maximum recovery time of 33 days.

Conclusion: In this study, all patients who underwent lateral pharyngoplasty with total preservation of the stylopharyngeus muscle reported complete normalization of swallowing with a recovery time up to 33 days.

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Figures

Figure 1
Figure 1
A: (without medial traction of the palatopharyngeal. Intraoperative aspect of the lateral pharyngoplasty with preservation of the stylopharyngeus muscle. 1: palatopharyngeal m.; 2: buccopharyngeal fascia; 3: stylopharyngeus m.; 4: palatoglossus m.; * crossover of the stylopharyngeus m. with the middle constrictor; (arrow) superior constrictor m; B: (with medial traction of the pharyngeal palate). Intraoperative view of the lateral pharyngoplasty, preserving the stylopharyngeus muscle. 1: palatopharyngeal m.; 2: buccopharyngeal fascia; 3: stylopharyngeus m.; 4: palatoglossus m.; * crossover of the stylopharyngeus m. with the middle constrictor; (arrow) superior constrictor m.
Graph 1
Graph 1
Assessing the deglutition difficulty after lateral pharyngoplasty, with the maximum (upper curve), minimum (lower curve) and middle (middle curve) scores assigned by the 20 patients who were assessed in a daily basis.
See this image and copyright information in PMC

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