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前舌及口底切除并远端皮瓣重建后的言语及吞咽功能

Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction.

作者信息

Pauloski B R, Logemann J A, Rademaker A W, McConnel F M, Heiser M A, Cardinale S, Shedd D, Lewin J, Baker S R, Graner D

机构信息

Northwestern University, Department of Communication Sciences and Disorders, Evanston, IL 60208-3540.

出版信息

J Speech Hear Res. 1993 Apr;36(2):267-76. doi: 10.1044/jshr.3602.267.

Abstract

The purpose of this study was to assess the postoperative functioning of oral cancer patients with resections of the anterior tongue and floor of mouth, reconstructed with distal flap closure. Speech and swallowing performance was assessed for 11 men and 5 women preoperatively and at 1 and 3 months postoperatively following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined using videofluoroscopy. Data were also collected on the number and duration of speech/swallowing treatment sessions, as well as the amount and duration of radiation therapy. Statistical analyses revealed that patients demonstrated a significant and severe impairment in speech and swallow functioning after surgery, with no recovery of function by 3 months post-healing. The degree of impairment in these patients may be related to the adynamic character of the distal flap used for reconstruction. Lack of improvement at the 3-month evaluation may be related to either the timing of postoperative radiation therapy or the low rate (44%) and amount of speech/swallowing treatment provided to these patients.

摘要

本研究的目的是评估采用远位皮瓣关闭术重建的前舌和口底切除术后口腔癌患者的术后功能。按照标准化方案,对11名男性和5名女性患者在术前、术后1个月和3个月时的言语和吞咽功能进行评估。言语任务包括简短对话的音频记录和标准清晰度测试;吞咽功能采用电视荧光透视检查。还收集了言语/吞咽治疗疗程的次数和时长,以及放射治疗的剂量和时长的数据。统计分析显示,患者术后言语和吞咽功能出现显著且严重的损害,愈合后3个月功能未恢复。这些患者的损害程度可能与用于重建的远位皮瓣的无动力特性有关。3个月评估时无改善可能与术后放射治疗的时机有关,也可能与为这些患者提供的言语/吞咽治疗的低比例(44%)和低剂量有关。

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