Gerstner AOH, Laffers W. [Integrity of swallowing apparatus-past, present, and future].
HNO 2021;
69:185-191. [PMID:
33438078 DOI:
10.1007/s00106-020-00990-2]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Swallowing is one of the most complex movement patterns. The integrity of the epithelial lining is essential.
OBJECTIVE
Which surgical techniques were developed at the beginnings of modern surgery and what methods are now available to maintain/reconstitute the integrity of the swallowing apparatus?
MATERIALS AND METHODS
This study comprises a selective literature search in early operation manuals and online archives, with incorporation of the authors' own experience.
RESULTS
Up until the 1950s, only very limited techniques were available to reconstruct the epithelial lining. Microvascular reanastomosed grafts were the game changer for reconstructive surgery, enabling reconstitution of the swallowing apparatus in primary surgery but also in challenging secondary interventions after insufficient or complicated primary therapy.
CONCLUSION
The need for anatomical and functional rehabilitation by reconstructive surgery is as pertinent as ever. Particularly in the oncological context, improved early detection and novel local treatment modalities could minimize treatment-associated damage to swallowing.
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