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超选择性动脉内化疗和放疗保器官治疗后双侧颈清扫术前后晚期舌癌患者吞咽功能的病例对照研究。

Swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy for organ preservation: a case-control study.

机构信息

Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.

Department of Gerontology and Gerodontology, Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Oral Radiol. 2019 Sep;35(3):230-238. doi: 10.1007/s11282-018-0341-0. Epub 2018 Aug 20.

Abstract

OBJECTIVE

This study aimed to evaluate swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy (CRT).

METHODS

A videofluoroscopic swallowing study (VFSS) was used to evaluate swallowing function in 10 patients with advanced tongue cancer before and after bilateral neck dissection.

RESULTS

Laryngeal penetration increased in the postoperative VFSS. Temporal analysis comparing two time points revealed that, after surgery, oral transit time increased significantly, but there was no difference in pharyngeal delay time or pharyngeal transit time. Spatial analysis revealed significant decreases after surgery in the maximum distance of upper esophageal sphincter (UES) opening, the maximum distance of hyoid bone movement in both the anterior and superior direction, and the maximum velocity of hyoid bone movement.

CONCLUSIONS

Laryngeal penetration and aspiration increased as a result of limited hyoid movement and diminished UES opening after bilateral neck dissection following superselective intra-arterial CRT for advanced tongue cancer.

摘要

目的

本研究旨在评估接受超选择性动脉内放化疗(CRT)后双侧颈清扫术治疗的晚期舌癌患者的吞咽功能。

方法

采用视频透视吞咽研究(VFSS)评估 10 例晚期舌癌患者双侧颈清扫术前后的吞咽功能。

结果

术后 VFSS 显示喉穿透增加。两个时间点的时间分析显示,术后口腔通过时间显著增加,但咽延迟时间或咽通过时间无差异。空间分析显示,术后上食管括约肌(UES)开口最大距离、舌骨前上方向最大移动距离和舌骨最大移动速度均显著降低。

结论

超选择性动脉内 CRT 治疗晚期舌癌后行双侧颈清扫术,由于舌骨运动受限和 UES 开口减小,导致喉穿透和吸入增加。

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