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放疗后的口腔感觉功能障碍。

Oral sensory dysfunction following radiotherapy.

作者信息

Bearelly Shethal, Wang Steven J, Cheung Steven W

机构信息

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, U.S.A.

Department of Otolaryngology-Head and Neck Surgery, University of Arizona, Tucson, Arizona, U.S.A.

出版信息

Laryngoscope. 2017 Oct;127(10):2282-2286. doi: 10.1002/lary.26591. Epub 2017 Apr 11.

Abstract

OBJECTIVES/HYPOTHESIS: To assess differences in oral tactile sensation between subjects who have undergone radiation therapy (XRT) compared to healthy controls.

STUDY DESIGN

Cross-sectional cohort comparison.

METHODS

Thirty-four subjects with a history of XRT were compared with 23 healthy controls. There was no difference in age (P = .23), but there were slightly more males in the XRT cohort (P = .03). The mean (standard deviation) time after XRT completion was 3.84 (4.84) years. Fifty-six percent of the XRT cohort received chemotherapy. Using our previously validated methodology to measure oral tactile sensory threshold quantitatively with Cheung-Bearelly monofilaments, sensory thresholds of four subsites (anterior tongue, buccal mucosa, posterior tongue, soft palate) were compared for the two cohorts.

RESULTS

Site-by-site comparisons showed higher forces were required for stimulus detection at all four subsites among subjects in the XRT cohort compared to healthy controls. Mean force in grams for XRT versus control cohorts were: anterior tongue, 0.39 (1.0) versus 0.02 (0.01); buccal mucosa, 0.42 (0.95) versus 0.06 (0.05); posterior tongue, 0.76 (1.46) versus 0.10 (0.07); and soft palate, 0.86 (1.47) versus 0.08 (0.05) (P < .001 for all comparisons). Combining all four subsites into a single metric to assess an overall level of oral tactile dysfunction, the XRT cohort had reduced sensation by 18.7 dB (P < .001).

CONCLUSIONS

After radiation therapy, the oral cavity and oropharynx exhibit global tactile sensory dysfunction, manifested by increased tactile forces required for stimulus detection. The magnitude of sensory impairment is 18.7 dB.

LEVEL OF EVIDENCE

3b. Laryngoscope, 127:2282-2286, 2017.

摘要

目的/假设:评估接受放射治疗(XRT)的受试者与健康对照者之间口腔触觉感觉的差异。

研究设计

横断面队列比较。

方法

将34例有XRT病史的受试者与23例健康对照者进行比较。年龄无差异(P = 0.23),但XRT队列中的男性略多(P = 0.03)。XRT完成后的平均(标准差)时间为3.84(4.84)年。XRT队列中有56%的受试者接受了化疗。使用我们先前验证的方法,用张氏-贝雷利单丝定量测量口腔触觉感觉阈值,比较了两组受试者四个亚部位(舌尖、颊黏膜、舌根、软腭)的感觉阈值。

结果

逐部位比较显示,与健康对照者相比,XRT队列中的受试者在所有四个亚部位检测刺激所需的力量更高。XRT组与对照组的平均克数力量分别为:舌尖,0.39(1.0)对0.02(0.01);颊黏膜,0.42(0.95)对0.06(0.05);舌根,0.76(1.46)对0.10(0.07);软腭,0.86(1.47)对0.08(0.05)(所有比较P < 0.001)。将所有四个亚部位合并为一个单一指标以评估口腔触觉功能障碍的总体水平,XRT队列的感觉降低了18.7 dB(P < 0.001)。

结论

放射治疗后,口腔和口咽表现出整体触觉感觉功能障碍,表现为检测刺激所需触觉力量增加。感觉损害程度为18.7 dB。

证据水平

3b。《喉镜》,2017年,第127卷,第2282 - 2286页。

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