Hirano M, Kuroiwa Y, Tanaka S, Matsuoka H, Sato K, Yoshida T
Department of Otolaryngology-Head and Neck Surgery, Kurume University, Japan.
Ann Otol Rhinol Laryngol. 1992 Feb;101(2 Pt 1):138-41. doi: 10.1177/000348949210100206.
Postoperative swallowing problems were investigated in 20 patients who had undergone various degrees of surgical resection for oral cancer. The swallowing problems were evaluated on the basis of type of food, degree of aspiration, and duration of postoperative nasogastric tube feeding. Two patients with tongue cancer who had had hemiglossectomy without reconstruction ate normal food without aspiration within a week after operation. Eight patients who had undergone two- to three-quarter glossectomy for tongue cancer ate gruel with no or occasional liquid aspiration. Among 4 patients who had had near-total or total glossectomy for tongue cancer, 3 ate thin gruel or liquid with occasional aspiration. The other could not eat orally because of consistent severe aspiration. One patient with mouth floor cancer underwent resection of the mouth floor in combination with hemiglossectomy and she ate gruel without aspiration. Among 5 patients with mouth floor cancer who had had surgical removal accompanied by near-total or total glossectomy, 3 ate gruel with no or occasional liquid aspiration, 1 ate thin gruel with no aspiration, and the other could not eat orally. A diagnosis of T4 lesions, extensive removal of the tongue base, removal of the geniohyoid and mylohyoid muscles, and removal of the lateral pharyngeal wall were significantly related to poor swallowing function.
对20例因口腔癌接受不同程度手术切除的患者进行了术后吞咽问题的调查。根据食物类型、误吸程度和术后鼻饲管喂养持续时间对吞咽问题进行评估。2例舌癌患者行半舌切除术且未进行重建,术后1周内可正常进食且无呛咳。8例因舌癌行四分之二至四分之三舌切除术的患者进食稀粥,无呛咳或偶尔有液体呛咳。在4例因舌癌行近全舌切除术或全舌切除术的患者中,3例进食稀粥或流食,偶尔有呛咳。另1例因持续严重呛咳无法经口进食。1例口底癌患者行口底切除术联合半舌切除术,进食稀粥无呛咳。在5例因口底癌行手术切除并伴有近全舌切除术或全舌切除术的患者中,3例进食稀粥无呛咳或偶尔有液体呛咳,1例进食稀粥无呛咳,另1例无法经口进食。T4期病变、广泛切除舌根、切除颏舌骨肌和下颌舌骨肌以及切除咽侧壁与吞咽功能差显著相关。