Effects of the postural technique on postoperative dysphagia in patients with tongue cancer: A comparison of improved cases with unimproved cases on head tilting toward the stronger side

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  • FUKASAWA Miki
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University
  • TAKAHASHI Koji
    Department of Oral Rehabilitation, School of Dentistry, Showa University
  • UYAMA Risa
    Department of Oral Rehabilitation, School of Dentistry, Showa University
  • HIRANO Kaoru
    Department of Oral Rehabilitation, School of Dentistry, Showa University
  • NAKAYAMA Hiroshi
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University
  • SEKI Kenji
    Department of Oral Radiology, School of Dentistry, Showa University
  • NAGUMO Masao
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University

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Other Title
  • 舌癌術後えん下障害患者に対する姿勢調節法の効果―健側傾斜姿勢の奏効例と非奏効例との比較―
  • ゼツガン ジュツゴ エンゲ ショウガイ カンジャ ニ タイスル シセイ チョウセツホウ ノ コウカ ケンソク ケイシャ シセイ ノ ソウコウレイ ト ヒソウコウレイ ト ノ ヒカク
  • A comparison of improved cases with unimproved cases on head tilting toward the stronger side
  • 健側傾斜姿勢の奏効例と非奏効例との比較

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Abstract

Postoperative dysphagia is often improved by postural compensatory techniques in patients with head and neck cancer. This study was done to evaluate the effects of postural technique on postoperative dysphagia in patients with tongue cancer. We compared improved cases with unimproved cases on head tilting toward the stronger side.<BR>Fifteen patients with dysphagia were subjects. All subjects swallowed 5ml of the contrast medium in both an upright position and with the head tilted toward the stronger side during videofluorographic (VF) examination. Eight patients (improved cases) showed aspiration in the upright position and no aspiration during head tilting. Seven patients (unimproved cases) showed aspiration in both the upright position and on head tilting.<BR>Tilting magnitude, vallecular angle, and epiglottic angle were measured on video prints. Pharyngeal delay time, pharyngeal passing time, and pharyngo-esophageal (PE) segment opening time were measured using a video motion analyzer. Retention amounts (intraoral, valleculae, and pyriform sinuses) were qualitatively evaluated on video prints.<BR>The results were as follows:<BR>1) Vallecular angle in the tilting posture was greater than that in the upright posture in 6 of the 8 improved cases.<BR>2) Vallecular angle in the tilting posture was smaller than that in the upright posture in 6 of the 7 unimproved cases.<BR>3) As compared with the upright position, pharyngeal delay time and pharyngeal passing time in the tilting posture were shorter in both the improved and the unimproved cases. The time difference between pharyngeal passing time and pharyngeal delay time in the tilting posture was a positive value in all improved case.<BR>4) PE segment opening time in the tilting posture was longer than that in the upright position in 5 of the 8 improved cases.<BR>5) PE segment opening time in the tilting posture was shorter than that in the upright position in 6 of the 7 unimproved cases.<BR>6) Intraoral retention amount after barium swallow during the tilting posture was mild in 7 of the 8 improved cases and in 6 of the 7 unimproved cases.<BR>7) Retention amounts in the valleculae and pyriform sinuses after barium swallow during the tilting posture were less in the improved cases than in the unimproved cases.

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