Does Swallowing Function Recover in the Long Term in Patients With Surgically Treated Tongue Carcinomas?

Abstract

1Abstract Purpose: The present study aims to measure the post-surgical swallowing function in patients five years after operative treatment of tongue carcinoma.Patients and Methods: Using a retrospective cohort study design, the investigators enrolled post-surgical patients treated for tongue carcinomas in Hokkaido University Hospital. The primary outcome variable was the Oropharyngeal Swallow Efficiency (OPSE) determined by videoflluoroscopic evaluation and the OPSE at present was compared with that at discharge.Other variables included present nutritional status (Body Mass Index: BMI, Serum Albumin), dietary intake, self-rating of the present swallowing function, and the occurrence of pneumonia.Statistical analysis used the paired t-test and Spearman's rank correlation.Results: The swallowing function was assessed in 20 patients (11 males and 9 females) subjected to surgical treatment of tongue carcinomas; the median age was 70 years (range 56-90 years) at the present evaluation. The mean values of the liquid OPSE and paste OPSE at present were 26.6±21.2 and 21.9±22.5 respectively. The mean values of BMI and serum albumin at present were 22.2±3.4 and 4.5±0.3g/dl respectively. All patients had a full oral intake of foods, with a mean self-rated value of 6.4±2.5, an acceptable value as evaluated by the patients.Pneumonia requiring hospitalization had not occurred in these patients.Conclusions: Long-term follow-up of patients following operative treatment of tongue carcinomas demonstrate acceptable levels of oral function and nutritional status despite objective measures of poor swallowing efficiency assessed using a videofluoroscopy.

Mandibular lingual release versus mandibular lip-split approach for expanded resection of middle–late tongue cancer: A case-control study

“…Devine et al reported that the MLR approach is associated with slightly worse oral motoresensory functions, such as mastication, swallowing, and speech, compared to the MS approach, probably due to the fact that the mylohyoid and digastric muscles attached to the mandible are transected in the MLR approach (Devine et al, 2001). Another fact disfavoring the MLR approach is that simultaneous reconstruction of a tongue defect, especially flap transfer, is technically difficult in this approach because of the presence of an intact mandible (Kruse et al, 2011;Cantù et al, 2006;Dziegielewski et al, 2010;Tei et al, 2012). However, our results show that in the scenario of compartmental tongue surgery, the MLR approach resulted in oral motoresensory restoration similar to that with the MS approach.…”

“…In contrast, in the MLR approach, the lower lip and the mandible remain intact, and the mylohyoid muscles and hyomandibular furrow are incised to retract the tongue from the submandibular triangle for resection. Findings in the current literature are contradictory with regard to whether the MLR approach is superior to the MS approach in terms of surgical effectiveness, morbidity, functional recovery, esthetic appearance, survival, and QoL, or vice versa (Devine et al, 2001;Cantu et al, 2006;Dziegielewski et al, 2010;Karatzanis et al, 2012;Tei et al, 2012).…”