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可摘局部义齿联合吞咽训练是口腔癌术后腭部缺损并伴有吞咽困难患者的一种有效的临床解决方案:一项前瞻性研究。

Removable partial prosthesis combined with swallowing training is an efficient clinical solution for oral cancer post-operation patients with palatal defect and dysphagia: a prospective study.

作者信息

Su Kai, Wang Yu-Jia, Yu Yan-Song, Zheng Xiu-Yuan, Huang Zhuo-Shan

机构信息

Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, 56 Lingyuan Road, Guangzhou, Guangdong, China.

Department of Stomotology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang Road, Guangzhou, Guangdong, China.

出版信息

Clin Oral Investig. 2023 Jan;27(1):305-312. doi: 10.1007/s00784-022-04725-1. Epub 2022 Oct 10.

Abstract

OBJECTIVE

Dysphagia is one of the major complications of oral cancer patients, and is disturbing thousands of patients worldwide. Our study aim to evaluate the clinical efficacy of prosthesis combined with swallowing training on palatal defect and dysphagia in post-operative oral cancer patients.

MATERIALS AND METHODS

Sixteen oral cancer patients with palatal defect and dysphagia post-operation were treated with removable prosthesis and individualized swallowing function training. Swallowing function of patients before and after treatment was analyzed and compared by videofluoroscopic swallowing examination. The severity of depression and life quality were evaluated by Depression Scale (SDS) and Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) scores, respectively.

RESULTS

Oral transit time (OTT) significantly shortened after treatment (P < 0.01), and Penetration-Aspiration Scale (PAS) scores was significantly higher after treatment (P < 0.001). Different consistency bolus showed different risk of aspiration. Thickened liquids were related to lower PAS scores (P < 0.001). SDS standard score was significantly lower after treatment (P < 0.05). The total score of FACT-H&N after treatment was significantly higher (P < 0.05). No patients came back for regressed swallowing function during the follow-up period (17.06 ± 2.376 months).

CONCLUSION

Removable prosthesis and swallowing training can significantly improve swallowing function, reduce depression degree, and improve quality of life (QOL).

CLINICAL RELEVANCE

Removable prosthesis combined with swallowing training is a cheap and effective method to improve QOL in patients with palate defect and dysphagia after oral cancer.

摘要

目的

吞咽困难是口腔癌患者的主要并发症之一,困扰着全球数以千计的患者。本研究旨在评估义齿联合吞咽训练对口腔癌术后腭部缺损及吞咽困难患者的临床疗效。

材料与方法

对16例口腔癌术后腭部缺损并伴有吞咽困难的患者采用可摘义齿及个性化吞咽功能训练进行治疗。通过电视荧光吞咽检查分析比较患者治疗前后的吞咽功能。分别采用抑郁自评量表(SDS)和癌症治疗功能评价量表-头颈部分(FACT-H&N)评估抑郁严重程度和生活质量。

结果

治疗后口腔通过时间(OTT)显著缩短(P<0.01),渗透-误吸量表(PAS)评分显著升高(P<0.001)。不同黏稠度的食团显示出不同的误吸风险。增稠液体与较低的PAS评分相关(P<0.001)。治疗后SDS标准分显著降低(P<0.05)。治疗后FACT-H&N总分显著升高(P<0.05)。随访期间(17.06±2.376个月)无患者出现吞咽功能倒退而复诊。

结论

可摘义齿及吞咽训练可显著改善吞咽功能,降低抑郁程度,提高生活质量(QOL)。

临床意义

可摘义齿联合吞咽训练是改善口腔癌术后腭部缺损及吞咽困难患者生活质量的一种廉价且有效的方法。

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