The Impact of Open Partial Horizontal Laryngectomy Type IIa on Swallowing: A Pre–Post Surgery Case Series Analyzed Using the Analysis of Swallowing, Physiology, Events, Kinematics, and Timing

Purpose: This study aimed to assess the impact of open partial horizontal laryngectomy Type IIa (OPHL-IIa) surgery on swallowing dynamics. OPHL-IIa surgery for laryngeal cancer Stages T1b–T4a offers a promising approach for tumor management, enabling continued oral intake without necessitating tracheostomy, even in the presence of altered pharyngeal and laryngeal anatomy. However, the effects of the surgery on swallowing function and physiology have not been described. Method: The ASPEKT(Analysis of Swallowing Physiology: Events, Kinematics, and Timing) Method was used to analyze pre- and postsurgery videofluoroscopic swallowing study recordings from five participants (four men, one woman; M age = 61 years; mean postsurgery evaluation at 71 days). The study focused on swallowing dynamics across thin, mildly thick, and extremely thick liquids, as defined by the International Dysphagia Diet Standardisation Initiative. Parameters of interest included Penetration–Aspiration Scale (PAS) scores, timing measures, and pixel-based measures of upper esophageal sphincter opening, pharyngeal area at rest (PhAR), pharyngeal area at maximum constriction, residue, and hypopharyngeal area below the laryngeal aditus. Results: Initial observations highlighted poor pharyngeal constriction presurgery. Postoperatively, there was a notable deterioration in PAS scores, degree of laryngeal vestibule closure, and pharyngeal constriction. Variable changes in PhAR were also noted, potentially reflecting the impact of surgical technique and postsurgical edema. All participants exhibited postsurgical enlargement of the hypopharynx. Conclusion: This study reveals significant changes in swallowing anatomy, function, and physiology following OPHL-IIa surgery, marked by compromised laryngeal vestibule closure, pharyngeal structural changes, and diminished pharyngeal constriction.