Coordnation of Breathing and Swallowing in Oral or Oropharyngeal Cancer Patients with Postoperative Dysphagia

• Project/Area Number: 11672386
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Clinical nursing
• Research Institution: Aichi Prefectural College of Nursing & Health
• Principal Investigator: KMAKURA Yayoi Aichi Prefectural College of Nursing & Health Nursing Professor, 看護学部, 教授 (00177560)
• Project Period (FY): 1999 – 2000
• Project Status: Completed (Fiscal Year 2000)
• Budget Amount: ¥2,100,000 (Direct Cost: ¥2,100,000); Fiscal Year 2000: ¥500,000 (Direct Cost: ¥500,000); Fiscal Year 1999: ¥1,600,000 (Direct Cost: ¥1,600,000)
• Keywords: Postoperative dysphagia / Oral or oropharyngeal cancer / Respirographic biofeedback / Respiration pattern / Deglutition training program / Nursing / 呼吸軌跡 / バイオフィードバック / 嚥下 / 嚥下性無呼吸 / 呼吸曲線

Research Abstract

This study examined respiration patterns during swallowing to evaluate a deglutition training program using respirographic biofeedback for oral or oropharyngeal cancer patients with postoperative dysphagia. The subjects were 11 normal female volunteers (mean age 19.5±0.7 ; young group) and 11 normal male volunteers (mean age 71.5±3.7 ; elderly group). Respirograms and submental surface electromyograms during swallowing 10 or 5 ml water were simultaneously recorded. In the young group, the frequency of respiration patterns was examined by test-retest at a month interval. In the young and elderly groups, they were examined when the subjects made an effort to swallow the bolus at the four instructed points on the respiration cycle figure (A : end of expiration ; B : middle of inspiration ; C : end of inspiration ; D : middle of expiration) with respirographic biofeedback using a computer screen.
The results showed that the test-retest correlation was 0.83 on the single laryngeal movement p attern (single type) in respiration patterns and 0.76 on the expiration-apnea-expiration pattern (eae type) in single type. The frequency of appropriate respiratory patterns at the A, B, C and D point was 52.7%, 7O.9%, 50.9% and 47.3% in the young group, and 43.6%, 20.0%, 45.5% and 40.0% in the elderly group, respectively. Swallowing at A, B, C and D point, the frequency of the safest respiratory patterns was 18.2%, 45.4%, 92.8% and 69.1% in the young group, and 30.9%, 67.3%, 83.6% and 54.5% in the elderly group, respectively.
These results suggested that the instruction to swallow the bolus at C point and respirographic biofeedback assured the safe respiration patterns for swallowing. Thus, eight cancer patients with postoperative dysphagia were allowed to follow this program with the permission of the ethics committee of the hospital. The respiration patterns altered the pattern of several laryngeal movements (piecemeal type) into the single type in 6 patients, and the number of laryngeal movements decreased in 2 patients.