The study of compensatory change of the pharynx rear wall

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K20506
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Surgical dentistry
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: HIRAI HIDEAKI 東京医科歯科大学, 大学院医歯学総合研究科, 助教 (60598895)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 舌癌 / 摂食嚥下機能 / ビデオ嚥下造影検査 / 咽頭後壁

Outline of Final Research Achievements

Recently, awareness about dysphagia is spreading. The tongue cancer patients are directly linked to dysphagia, because their tongue which to make a food bolus and to feed into pharynx are resection. This time, I hypothesized that the posterior pharyngeal wall, induce a swallowing pressure by contacting with tongue base, may charge out compensatory after surgery. I implemented videofluoroscopic examination of swallowing(VFSS) to verify this hypothesis. 56 out of 58 patients with hemiglossectomy or more were able to take orally. The remaining 2 cases were made a gastrostomy. However, swallowing training made them possible to take orally. In this study, no patients acknowledged compensatory change of the posterior pharyngeal wall.

Free Research Field

口腔外科

Academic Significance and Societal Importance of the Research Achievements

口腔の機能は構音や摂食嚥下を主としている。癌により舌の半分以上を切除した場合、欠損部は動きの伴わない皮弁で再建することとなる。その際は残存舌が代償性により働くが、舌根部と接触し、嚥下圧を形成する咽頭後壁も同様に代償性変化を来たすのではないかという仮説をたてた。結果的には代償性変化は認めなかったが、舌の半分以上を失った患者さんのほとんどが適切な訓練により経口摂取が可能であったことが証明された。