I am working in the field of Head and Neck cancer. I see laryngectomy patients and , as with this type of surgery the vagus nerve is severed bilaterally, and there might also be a partial pharyngectomy involved. In any case the pharynx is reconstructed so that now the food passage and airway are separated from each other. The patient now breathes through a hole in the neck. I understand the vagus nerve supplies the oesophagus, but I do not understand what it does. What I do know is that most of my laryngectomy patients suffer from moderate to severe backflow as well as reflux. I would like to know if the surgery impacts on the efficiency of the cardiac sphincter (Lower oesophageal sphincter)
The vagus nerves are not sacrificed during a normal laryngectomy. Reflux is a common problem, but laryngectomy does not affect reflux. Laryngectomy does not impact the LE sphincter.
Thank you, Willard and Rachel!
Willard: could you tell me why I see so much issue with reflux in laryngectomies? I thought it might have to do with the vagus. Could it have to do with increased pressure in the oesophagus due to airflow after surgical voice restoration? You can see on videofluoroscopy that during attempted speech air enters not just the space in the oesohagus between the voice prosthesis and the vibrating segment but in most cases it flows back to inflate more distal parts of the oesohagus.
Does anyone know of a study that has compared laryngectomies, laryngopharyngectomies and SVR VS Oesophageal speech VS E-larynx users in terms of reflux issues?
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