DSA study on dysphagic patients induced by oral malignant tumor

本研究的目的是利用数字血管造影系统来阐明癌症治疗对舌癌患者吞咽模式的影响。比较放疗前后吞咽的差异，发现放疗后咽部延迟时间延长（定义为下颌骨后支处的中头直到触发咽部吞咽所花费的时间，显示喉部抬高），中量越少，这种现象越明显。部分病例出现吞咽障碍，如过早吞咽、喉穿、口腔、食管入口处和食管谷内有少量残留物等。放疗后舌切除再造术前后的吞咽功能恢复表现为造影剂失控、分咽、误吸及术后残留于口腔、食管入口、食管谷等处。除了这些品质，我们观察到时间的变化，如延长口腔通过时间，咽通过时间，咽延迟时间。部分皮瓣较小的患者吞咽障碍较其他患者严重。因此，吞咽障碍的出现可能不仅是由于舌运动困难，但重建皮瓣的体积。我们研究了“缩颏”的立场，术后误吸患者，以改善吞咽障碍。结果表明，减少误吸，在一些患者。有效和无效之间的区别还不清楚。我们建议通过透视检查来确定缩下巴的姿势是否有效。

The purpose of this study was to clarify the effect of the cancer therapy on the swallowing pattern of tongue cancer patients using the digital angiographic system.Compairsion of swallowings before and after radiotherapy revealed the prolonged pharyngeal delay time (defined as the time it takes the medium head at the posterior ramus the of mandible until the triggering of the pharyngeal swallow, which showing the laryngeal elevation) after radiation therapy, the less medium volume tended to enhance this phenomenon more. In some cases, swallow disturbances, such as premature swallow, laryngeal penetration, and a little residue in the oral cavity, the valleculae and the entrance ofesophagus were observed after swalloing. These findings suggested the might increase the risk of swallowing disturbances.Compairsion of swallowing before and after the surgery, that is tongue resection and reconstruction after radiotherapy, showed lost control of the contrast medium, divided swallows, aspirations and the residue in the oral cavity, the valleculae and the entrance of esophagus after the operation. In addition to these qualities, we observed temporal change, such as prolonged oral transit time, pharyngeal transit time, and pharyngeal delay time. Some patients which smaller flap, exhibited more severe swallowing disturbances than the others. Therefore, swallowing disturbances might appear not only due to the difficulty in tongue movement, but also the volume of the reconstructed flap.We studied the effect of 'Chin-tucked' posture on the patients with aspiration after surgical operation, to improve swallowing disorders. The results showed to reduce aspiration, in some patients. It has not been clear what is the difference between effective and non-effective. We would recommend fluoroscopy to ascertain the chin-tucked posture works.