SVIBOR - Project code: 3-01-215

MINISTRY OF SCIENCE AND TECHNOLOGY

Strossmayerov trg 4, HR - 10000 ZAGREB
tel.: +385 1 459 44 44, fax: +385 1 459 44 69
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Project code: 3-01-215


FUNCTION OF THE AERODIGESTIVE CROSSING AFTER SURGERY


Main researcher: PANSINI, MIHOVIL (34882)


Assistants
Type of research: developmental
Duration from: 01/01/90. to 12/31/94.
Papers on project (total): 47
Papers on project quoted in Current Contents: 3
Institution name: Bolnica "Sestre milosrdnice", Zagreb (134)
Department/Institute: Department of otrhinolaryngology and head and neck surgery
Address: 10000 Zagreb, Vinogradska c. 29
City: 41000 - Zagreb, Croatia
Communication
Phone: 385 (01)174-666
Fax: 385 (01)172-453
Summary: The authors deal with compensatory disturbances of the aerodigestive crossing on an experimental model. The changes of an acid basal status are analyzed following bilateral nose obstruction in rats. Electromyography of the genioglossal muscle activity shows that air ingestion into esophagus is due to air respiration. An analysis of both the voice and speech quality following total laryngectomy is also performed with respect to three types of rehabilitation procedure. The fistula speech is found to be nearly the same as that in normal speakers. Electromyography of the muscles participating in the articulation procedure has been made, and a comparison of the muscles to other sorts of movements and reflexes has been done so as to discuss the reflex arches peculiar to speech. Following the operation on the aerodigestive crossing in the case of total laryngectomy we analysed speciments using the method of macroscopic horizontal slices. The macroscopic horizontal slices technique has proven to be the efficient technique for scientific evaluation of the neoplastic infiltration of laryngeal cartilages. We analysed consequences following intubation on the aerodigestive crossing. The complications of intubation were found in trachea, larynx and lower respiratory pathways. The swallowing difficulties were analysed in the patients who had been subdued to operations on the structures involved in second stage on the swallowing act. In the group of patients with enlarged thyroid gland that compressed aerodigestive crossing, we measured thyroid hormons.

Keywords: aerodigestive crossing, respiratory function, electromyography, genioglossus muscle, nose obstruction, postoperative aspiration, ezophageal speech, vocal fistula speech, vibratory aid speech, intubation, swallowing

Research goals: The primary aim of the research was the exploration of respiratory function and crucial problems of compensatory disturbances of the aerodigestive crossing. For this purpose bilateral nasal abstruction was induced on an experimental model. What the authors expected to occur were the changes of the acidobasal status, however what they found were the respiratory acidosis, hypercapnia, hypoxemia and increase in the serum bicarbonate values. The respiratory function was studied on a group of the laryngectomized patients. The result of the study has shown that the application of cold air (temperature 26 degrees C, flow 16 l/min) leads to significant drop in frequency and alveolar CO2 concentration, and to the rise in tidal volume. Also the aim of the study was to evaluate disturbances of swallowing in the laryngectomees following surgery. Postoperative aspiration that occured during the swallowing in some of the patients was found to be primarily due to a reduced tongue motility and to the lack of the tongue root. The disability to receive the food in a physiologic manner was also due to the same cause. Likewise the aim of the research was to evaluate the voice and speech qualities in the patients following laryngectomy with respect to three types of rehabilitation procedure: ezophageal speech, fistula speech and vibrator speech.
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