Recovery from Postsurgical Swallowing Dysfunction in Patients With Oral Cancer

Abstract

TEL＆Fax 81-11-706-42831 Purpose: The present study was focused on a comparison of post-surgical oropharyngeal swallow efficiency and medical status indicators. Study design: The swallowing function was assessed in 25 patients (18 males and 7 females) with oral cancer. The swallowing function was assessed preoperatively, and 1, 6, and 12 months and in some cases more than 24 months after surgery. Assessment of the swallowing function consisted of videofluoroscopic evaluation (oropharyngeal swallow efficiency; OPSE) and details of the method of nutrition, diet level, nutritional condition, and occurrence of pneumonia. Results: Post-surgically OPSE did not recover to the preoperative level more than 12 months after surgery. Twenty-one patients (84%) had full oral intake and only three patients (12%) showed poorer nutritional conditions compared to the pre-surgery state. Aspiration pneumonia did not occur more than 12 months after surgery. Conclusions: The patients in the present study showed stable medical status and functional swallowing at the final evaluation despite of the insufficient recovery of the oropharyngeal swallow efficiency revealed by videofluoroscopic evaluation .

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

“…These results indicate that the patients in the present study have maintained good nutritional status for more than five years post-surgically. For the oral food intake, the food consistency or normalcy of diet within 1 year, post-surgery for patients with head and neck cancers, 22-86% have been reported to eat normal diets and to ingest regular masticated or soft foods 6,7,913,18 . The long-term status, 8.6 years (range 2.5-17.5years) post-surgically, was reported by Friedlander 13 , who evaluated 26 patients who had undergone tongue base resection by the Karnofsky Performance Scale.…”

“…These patients may be considered to be able to ingest orally, Aspiration has been reported in up to 44% of patients with surgically treated oral and oropharyngeal cancers with free-flap reconstruction, in follow-up studies within one year of the treatment 6 , and the incidence of aspiration in patients treated with chemoradiation was reported as somewhat higher 9 . Previously, we have reported the incidence of aspiration as 12% for liquid and 4% for paste swallowing for patients with oral carcinomas treated with preoperative radiation and surgery, at a 1 year post-intervention survey 7 . In the present study, the incidence of aspiration was 15% for liquid and 5% for paste swallowing.…”

“…Evaluation of the post-surgical swallowing function has been performed mainly with videofluoroscopic measurements [1][2][3][4][5][6][7][8][9][10][11][12] . The post-surgical swallowing function observed with videofluoroscopic measurements [1][2][3][4][5][6][7][8][9][10][11] has been evaluated with relatively short-term follow-up periods, such as follow-up surveys within one year of the treatment.…”

“…The post-surgical swallowing function observed with videofluoroscopic measurements [1][2][3][4][5][6][7][8][9][10][11] has been evaluated with relatively short-term follow-up periods, such as follow-up surveys within one year of the treatment. Because oral cancer patients are a high risk category both for developing local recurrences, regional or distant metastasis, as well as for developing second primary cancers, long-term periodic follow-up is essential for these patients.…”

“…The investigators hypothesize that the post-surgical swallowing function evaluated by the videofluoroscopic examination did not recover during the long-term follow-up. The specific aims of the study were to compare the present Oropharyngeal Swallow Efficiency (OPSE) with that at discharge and with that has been reported in other follow-up studies 7,16,17 , to compare the present nutritional status (BMI and serum albumin) and food consistency of the current eating to that at discharge, to determine a self-rating of the present swallowing function, and the occurrence of pneumonia. Further, the occurrence of penetration and aspiration evaluated by the videofluoroscopic examination were also determined.…”