Rieger Jana, Seikaly Hadi, Jha Naresh, Harris Jeffrey, Williams David, Liu Richard, McGaw Tim, Wolfaardt John
Craniofacial Osseointegration and Maxillofacial Prosthetic Rehabilitation Unit, Caritas Health Group, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta T5R 4H5, Canada.
Arch Otolaryngol Head Neck Surg. 2005 Feb;131(2):140-5. doi: 10.1001/archotol.131.2.140.
To assess swallowing outcomes in patients with oropharyngeal carcinoma in relation to the Seikaly-Jha procedure for submandibular gland transfer (SJP). The SJP has recently been described as beneficial in the prevention of xerostomia induced by radiation therapy in patients with head and neck cancer.
Inception cohort.
University-affiliated primary care center.
A phase 2 clinical trial was conducted from February 1, 1999, through February 28, 2002, to evaluate SJP in patients with head and neck cancer. During that period, a consecutive sample of 51 patients who underwent surgical resection and reconstruction with a radial forearm free flap for oropharyngeal carcinoma were referred for functional assessment of swallowing after completion of adjuvant radiation therapy. At 6 months after surgery, swallowing assessments for 24 patients were available.
The cohort of 24 patients included 13 who had preservation of 1 submandibular gland (SJP group) and 11 who did not (control group).
Quantitative and qualitative aspects of swallowing were obtained to determine whether patients in the SJP group performed more optimally than those in the control group.
Baseline and stimulated salivary flow rates were significantly different between groups. Patients in the SJP group were able to move the bolus through the oral cavity and into the pharynx faster than those in the control group. In addition, patients in the SJP group swallowed less often per bolus than patients in the control group. The complete swallowing sequence was twice as long in controls.
The SJP for submandibular gland transfer appears to be beneficial in promoting more time-efficient swallowing behaviors. This efficiency has implications for the overall well-being and nutritional status of patients with head and neck cancer.
评估口咽癌患者接受下颌下腺转移的Seikaly-Jha手术（SJP）后的吞咽结果。SJP最近被描述为对头颈部癌患者预防放疗引起的口干有益。
起始队列研究。
大学附属初级保健中心。
1999年2月1日至2002年2月28日进行了一项2期临床试验，以评估SJP在头颈部癌患者中的效果。在此期间，连续抽取51例接受口咽癌手术切除并采用游离桡侧前臂皮瓣重建的患者，在辅助放疗完成后接受吞咽功能评估。术后6个月，可获得24例患者的吞咽评估结果。
24例患者队列中，13例保留了1个下颌下腺（SJP组），11例未保留（对照组）。
获取吞咽的定量和定性方面的信息，以确定SJP组患者的表现是否优于对照组。
两组间基线和刺激唾液流速存在显著差异。SJP组患者能够比对照组患者更快地将食团通过口腔送入咽部。此外，SJP组患者每次食团吞咽次数少于对照组。对照组的完整吞咽过程时间是SJP组的两倍。
下颌下腺转移的SJP似乎有利于促进更高效的吞咽行为。这种效率对头颈部癌患者的整体健康和营养状况有影响。
