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舌功能及其对口腔癌治疗患者咀嚼性能的影响:一项为期五年的前瞻性研究。

Tongue function and its influence on masticatory performance in patients treated for oral cancer: a five-year prospective study.

机构信息

Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, 3508 GA, Utrecht, The Netherlands.

Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Support Care Cancer. 2020 Mar;28(3):1491-1501. doi: 10.1007/s00520-019-04913-y. Epub 2019 Jul 4.

Abstract

PURPOSE

The purpose of this study was to observe the impact of oral oncological treatment, including the recovery of several tongue functions (force, mobility, and sensory functions), and to determine the influence of these functions on masticatory performance.

MATERIALS AND METHODS

Masticatory performance and tongue force, mobility, and sensory functions were determined in 123 patients with oral cavity cancer. The assessments were performed 4 weeks before treatment and 4 to 6 weeks, 6 months, 1 year, and 5 years after treatment. Generalized estimation equations and mixed model analyses were performed, correcting for previously identified factors in the same population.

RESULTS

A significant deterioration in tongue mobility and sensory function was observed in patients with mandible and tongue and/or floor-of-mouth tumors. Better tongue force and sensory function (thermal and tactile) positively influenced masticatory performance, and this effect was stronger where fewer occlusal units were present. The effect of both the tongue force and maximum bite force was weaker in dentate patients in comparison with patients with full dentures. A web-based application was developed to enable readers to explore our results and provide insight into the coherence between the found factors in the mixed model.

CONCLUSIONS

Tongue function deteriorates after oral oncological treatment, without statistically significant recovery. Adequate bite and tongue forces are especially important for patients with a poor prosthetic state. Patients with sensory tongue function deficits especially benefit from the presence of more occluding pairs.

摘要

目的

本研究旨在观察口腔肿瘤治疗对包括舌的几种功能(力量、活动度和感觉功能)恢复的影响,并确定这些功能对咀嚼性能的影响。

材料和方法

对 123 例口腔癌患者的咀嚼性能和舌力、活动度和感觉功能进行了评估。评估在治疗前 4 周以及治疗后 4-6 周、6 个月、1 年和 5 年进行。使用广义估计方程和混合模型分析,校正了同一人群中先前确定的因素。

结果

下颌和舌及/或口底肿瘤患者的舌活动度和感觉功能明显恶化。更好的舌力和感觉功能(热觉和触觉)对咀嚼性能有积极影响,在存在较少咬合单位的情况下,这种影响更强。与全口义齿患者相比,有牙患者的舌力和最大咬合力的影响较弱。开发了一个基于网络的应用程序,使读者能够探索我们的结果,并深入了解混合模型中发现的因素之间的一致性。

结论

口腔肿瘤治疗后舌功能会恶化,没有明显的恢复。足够的咬合力和舌力对于口腔修复状态较差的患者尤为重要。具有感觉性舌功能缺陷的患者,更多的咬合对会对其有较大帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfe1/6989568/52aeac524099/520_2019_4913_Fig1_HTML.jpg

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