Study of dysphagia before and after surgery in oral cancer patients

Research Project

Project/Area Number	17592113
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Single-year Grants
Section	一般
Research Field	Surgical dentistry
Research Institution	Nihon University
Principal Investigator	NAMAKI Shunsuke (2006) Nihon University, School of Dentistry, Assistant, 歯学部, 助手 (70386077) 松本光彦 (2005) 日本大学, 歯学部, 教授 (70096907)
Co-Investigator(Kenkyū-buntansha)	UEDA Kouichiro Nihon University, School of Dentistry, Professor, 歯学部, 教授 (80313518) KOSHIKAW Noriaki Nihon University, School of Dentistry, Professor, 歯学部, 教授 (80130491) NKAJIMA Ichiro Nihon University, School of Dentistry, Professor, 歯学部, 助教授 (90198078) 生木俊輔日本大学, 歯学部, 助手 (70386077)
Project Period (FY)	2005 – 2006
Project Status	Completed (Fiscal Year 2006)
Budget Amount *help	¥3,600,000 (Direct Cost: ¥3,600,000) Fiscal Year 2006: ¥100,000 (Direct Cost: ¥100,000) Fiscal Year 2005: ¥3,500,000 (Direct Cost: ¥3,500,000)
Keywords	oral cancer / dysphagia / flap correction / orofacial movement / dopamine receptor / 顎顔面領域の運動 / 鼻咽喉内視鏡検査
Research Abstract	The extent of dysphagia after the resection of oral cancer should largely depend on the location of the cancer, the range of resection, and the method of reconstruction. Dysphagia due to a substantial loss of the tongue and restrictions in the movement of the remaining tongue resulting from flap correction was observed in patients who underwent oral cancer surgery. Therefore, a technique of improving swallowing disorder caused by flap correction was designed using a tongue pressure monitor during the surgery, enabling the increase in the area of the tongue that can move. We also evaluated 7 patients who underwent oral cancer surgery and reconstruction of the forearm free flap. Tongue pressure in all patients increased during and 4 weeks after the flap correction surgery in comparison with tongue pressure before the surgery. Six months after the surgery, tongue pressure was almost the same as the pre-flap correction surgery level. As for preoperative videofluorography, the inflow of barium to the pharynx before swallowing occurred in all patients, and the retention of barium in the oral cavity after swallowing occurred in five patients. As for postoperative videofluorography carried out 4 weeks, and 6 months after flap correction surgery, barium inflow to the pharynx before swallowing and barium retention in the oral cavity after swallowing were either not observed or their incidences had decreased in the all patients. We can conclude that the swallowing disorder caused by flap correction can be improved using a tongue pressure monitor, enabling resection with minimal invasive surgery of skin flap and cicatrix. Furthermore, the swallowing function determined by postoperative videofluorography was improved by this method.