DSA study on dysphagic patients induced by oral malignant tumor

1997 Fiscal Year Final Research Report Summary

• Project/Area Number: 08672156
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: 病態科学系歯学(含放射線系歯学)
• Research Institution: HIROSHIMA UNIVERSITY
• Principal Investigator: TANIMOTO Keiji Hiroshima University, Dental School, Professor, 歯学部, 教授 (10116626)
• Co-Investigator(Kenkyū-buntansha): YAMADA Toshikazu Hiroshima University, Dental School, Research Associate, 歯学部, 助手 (10263724) ; OTANI Keiko Hiroshima University, Dental School, Research Associate, 歯学部, 助手 (20243587) ; SUEI Yoshikazu Hiroshima University, Dental Hospital, Research Associate, 歯学部・附属病院, 助手 (10206378) ; FUKUDA Tomiko Hiroshima University, Dental Hospital, Assistant Professor, 歯学部・附属病院, 講師 (90029984) ; SUGIYAMA Masaru Hiroshima University, Dental School, Associate Professor, 歯学部, 助教授 (70187681)
• Project Period (FY): 1996 – 1997
• Keywords: DYSPHAGIA / TANGUE CANCER / RADIATION THERAPY / CHIN-TUCKED POSTURE

Research Abstract

The purpose of this study was to clarify the effect of the cancer therapy on the swallowing pattern of tongue cancer patients using the digital angiographic system.
Compairsion of swallowings before and after radiotherapy revealed the prolonged pharyngeal delay time (defined as the time it takes the medium head at the posterior ramus the of mandible until the triggering of the pharyngeal swallow, which showing the laryngeal elevation) after radiation therapy, the less medium volume tended to enhance this phenomenon more. In some cases, swallow disturbances, such as premature swallow, laryngeal penetration, and a little residue in the oral cavity, the valleculae and the entrance ofesophagus were observed after swalloing. These findings suggested the might increase the risk of swallowing disturbances.
Compairsion of swallowing before and after the surgery, that is tongue resection and reconstruction after radiotherapy, showed lost control of the contrast medium, divided swallows, aspirations and the residue in the oral cavity, the valleculae and the entrance of esophagus after the operation. In addition to these qualities, we observed temporal change, such as prolonged oral transit time, pharyngeal transit time, and pharyngeal delay time. Some patients which smaller flap, exhibited more severe swallowing disturbances than the others. Therefore, swallowing disturbances might appear not only due to the difficulty in tongue movement, but also the volume of the reconstructed flap.
We studied the effect of 'Chin-tucked' posture on the patients with aspiration after surgical operation, to improve swallowing disorders. The results showed to reduce aspiration, in some patients. It has not been clear what is the difference between effective and non-effective. We would recommend fluoroscopy to ascertain the chin-tucked posture works.