oral cancer

北海道歯学会

北海道歯学雑誌

Purpose : The purpose of this study was to estimate postoperative changes of volume and morphology of pharynx and evaluate the relationship between the changes and swallowing functions by videofluoroscopy in patients with surgically treated oral cancer. Patients and methods : We retrospectively analyzed the medical records of patients diagnosed with oral cancer who were treated surgically in Hokkaido University Hospital from January 2002 to March 2010. All patients were performed reconstruction with the free flap. We evaluated the volume and morphology of the pharynx using CT scan at preoperatively and at 6, 12 and 24 months after surgery. Assessment of the swallowing function was performed through videofluoroscopic evaluation at more than 24 months postoperatively. Additionally, the duration of tongue base contact to posterior pharyngeal wall was measured by using videofluoroscopy. Results : Twenty one patients （13 males and 8 females） were enrolled in this study. Of 21 patients, 14 underwent partial or subtotal glossectomy and 7 patients mandibular resection. This study shows that the volume of the pharynx after surgery was changed in some cases and unchanged in others. Some patients had larger antero-posterior diameters of pharynx than preoperation. Patients whose volume of pharynx increased showed poor swallowing function. They showed aspiration or penetration and reverse of bolus into the oral cavity and pharyngeal residue. And their duration of tongue base contact to posterior pharyngeal wall was significantly shorter than others （p<0.01）. Conclusion : In patients with oral cancer swallowing function after surgery was related to the volume of oropharynx especially antero-posterior pharyngeal diameters.