The study of silent aspiration of head-neck tumor patient assessed by deglutition scintigraphy during sleep and rCBF SPECT during deglutition

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It is very important to discover silent aspiration of head and neck cancer and predict the onset of aspiration pneumonia. In addition, it is known that risk of aspiration increases when there is abnormality in central nervous function. Therefore, appropriate evaluation of cerebral highly advanced dysfunction is important for a prediction of aspiration pneumonia and prevention. The current study was to develop diagnose silent aspiration and analyzes rCBF alteration of head and neck tumor patient having risk with aspiration pneumonia. We let Tc-99m-DTPA take medicine for the head and neck tumor patient, and affirmation of silent aspiration defines the case that imaging at 24 hours show lung tracer uptake. We estimated rCBF distribution of silent aspiration patient by SPECT and SPM, 3DSSP analysis. As for the results in 20 head and neck tumor patients, conventional scan was normal, but the silent aspiration patient was found in 11 at 24 hours later. By SPM analysis, decrease of rCBF was noted in basal ganglia and the cerebral cortex including medial frontal gyrus. A diagnosis of silent aspiration was difficult by the conventional method using contrast media under fluoroscopy. But the current study with serial observation demonstrated high incidence silent aspiration in head and neck tumor. In addition, basal ganglia and cerebral cortex including medial frontal gyrus were suggested to contribute to regulate deglutition function. These rCBF abnormalities seem to be effective findings for an onset prediction of aspiration pneumonia. In conclusion, serial Tc-99m-DTPA deglutition scintigraphy during sleeping time was confirmed as effective methods for diagnosing silent aspiration. rCBF analysis was also effective tool for predicting the deglutition functional regulation deficiency.