Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, School of Medicine, University of Louisville, Louisville, Kentucky, United States of America.
School of Medicine, University of Louisville, Louisville, Kentucky, United States of America.
PLoS One. 2022 May 13;17(5):e0268457. doi: 10.1371/journal.pone.0268457. eCollection 2022.
Swallowing impairments are a major complication of radiation treatment for oropharyngeal cancers, influencing oral intake and quality of life. The timing and functional consequences of radiation treatment on the swallowing process is not clearly understood. A rodent radiation injury model was used to investigate the onset of oral and pharyngeal dysfunctions in deglutition related to radiation treatment. This study tested the hypothesis that (Wall et al., 2013) alterations in normal biting, licking, and swallowing performance would be measurable following 64Gy of fractionated radiation to the submental muscles; and (Kotz et al., 2004) radiation will affect the animal's general well-being as measured via burrowing activity. Seven rats received radiation using a clinical linear accelerator given in 8 fractions of 8Gy and another seven animals received sham anesthesia only treatment. Swallowing bolus transit/size was assessed via videofluoroscopy, tongue movement during drinking was measured via an electrical lick sensor, and biting was analyzed from acoustic recordings of a vermicelli pasta test. Burrowing activity was measured by the amount of gravel substrate displaced within a container. Measurements were taken at baseline, during treatment (1-4 weeks), and after completion of treatment (weeks 5 & 6). Decreases in licking frequency and increases in inter-lick interval were observed 5- and 6-weeks post-treatment. Significant decreases in burrowing performance, swallowing frequency, and inter-swallow interval were observed starting the last week of treatment and continuing up to 2-weeks after completion. Results suggest that tongue dysfunction is one of the first treatment related feeding problems to present immediately after the completion of radiation to the submental muscles.
吞咽障碍是头颈部癌症放射治疗的主要并发症之一,影响口腔摄入和生活质量。目前对于放射治疗对吞咽过程的时间和功能影响还没有明确的认识。本研究采用啮齿动物放射损伤模型,研究与放射治疗相关的吞咽过程中口腔和咽部功能障碍的发生时间。该研究检验了以下假设:(Wall 等人,2013 年)在下颔舌骨肌接受 64Gy 分次照射后,正常的咀嚼、舔舐和吞咽功能会发生改变;(Kotz 等人,2004 年)放射治疗会影响动物的一般舒适度,可通过挖掘活动进行测量。7 只大鼠接受了临床直线加速器给予的 8 次 8Gy 分次照射,另 7 只动物仅接受了假麻醉处理。通过视频透视法评估吞咽团块通过/大小,通过电舔传感器测量饮水时的舌运动,通过对通心粉测试的声学记录分析咀嚼。通过容器内砾石基质的位移量测量挖掘活动。在基线、治疗期间(1-4 周)和治疗完成后(第 5 和第 6 周)进行测量。在治疗后 5-6 周观察到舔舐频率降低和舔舐间隔增加。从治疗的最后一周开始并持续到治疗完成后 2 周,观察到挖掘性能、吞咽频率和吞咽间隔显著降低。结果表明,在颏舌骨肌接受放射治疗后立即,舌功能障碍是与治疗相关的最早出现的进食问题之一。