Montesi A, Pesaresi A, Serri L, Salmistraro D, Cavalli M L, Segoni A
Servizio di Radiologia Ospedale Regionale Umberto I, Ancona.
Radiol Med. 1990 Jan-Feb;79(1-2):48-58.
Swallowing disorders due to oro-pharyngo-laryngeal cancer, or due to the consequences of surgical resection and radiotherapy, should be accurately evaluated to manage properly both nutritional therapy and dysphagia rehabilitation techniques. The site, size, and local spread of such tumors and, especially, the nature and extent of surgical resection and reconstruction, are important factors which are closely related to the functional disorders of deglutition. The aim of this paper is to demonstrate video-fluoroscopy capability to evaluate the incidence, type, and severity of such functional disorders. For this purpose we studied by means of dynamic radiology 23 patients with oral cancer and 33 patients with pharyngeal-laryngeal cancer, most of them after surgical and/or radiological treatment. Eighty-four per cent of the patients had swallowing disorders such as poor oral processing (25%), retention of the bolus in the pharynx (41%), penetration (41%) or aspiration (37%) of the bolus in the airway, dysmotility of upper esophageal sphincter (9%), and structural lesions (61%). The association of these functional disorders was closely related to the pathological background of each patient. In conclusion, a dynamic radiological study is recommended for both pre and postoperative evaluation of these patients, to choose the appropriate nutritional therapy and dysphagia rehabilitation technique.
由于口咽喉癌或手术切除及放疗的后果导致的吞咽障碍,应进行准确评估,以便妥善管理营养治疗和吞咽困难康复技术。此类肿瘤的部位、大小和局部扩散情况,尤其是手术切除和重建的性质及范围,是与吞咽功能障碍密切相关的重要因素。本文旨在展示视频荧光透视评估此类功能障碍的发生率、类型和严重程度的能力。为此,我们通过动态放射学研究了23例口腔癌患者和33例咽喉癌患者,其中大多数患者接受了手术和/或放射治疗。84%的患者存在吞咽障碍,如口腔处理能力差(25%)、食团在咽部滞留(41%)、食团进入气道(41%)或误吸(37%)、食管上括约肌运动障碍(9%)以及结构病变(61%)。这些功能障碍的关联与每位患者的病理背景密切相关。总之,建议对这些患者进行术前和术后动态放射学研究,以选择合适的营养治疗和吞咽困难康复技术。