DSA study on dysphagic patients induced by oral malignant tumor

口腔恶性肿瘤所致吞咽困难患者的DSA研究

• 批准号: 08672156
• 负责人: TANIMOTO Keiji
• 金额: $ 1.66万
• 依托单位: HIROSHIMA UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08672156/
• 关键词: DYSPHAGIA; TANGUE CANCER; RADIATION THERAPY; CHIN-TUCKED POSTURE; X線映画; 嚥下; 喉頭流入; 誤嚥

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.

本研究的目的是利用数字血管造影系统阐明癌症治疗对舌癌患者吞咽模式的影响。通过比较放疗前后的吞咽行为，发现放疗后咽延迟时间（定义为下颌后支中头到触发咽部吞咽所需的时间，显示喉部抬高所需的时间）延长，放疗后的吞咽延迟时间越长，放疗后的吞咽延迟时间越长。 中等音量更倾向于增强这种现象。部分病例吞咽障碍，如吞咽过早、喉部穿透，吞咽后口腔、谷部、食管入口处有少量残留物。这些结果提示可能会增加吞咽障碍的风险。舌切除和放疗后重建手术前后的吞咽对比显示，术后造影剂失控、吞咽分次、误吸以及口腔、谷部和食管入口处的残留物。除了这些品质之外，我们还观察到时间变化，例如口腔通过时间、咽部通过时间和咽部延迟时间延长。一些皮瓣较小的患者比其他患者表现出更严重的吞咽障碍。因此，出现吞咽障碍的原因不仅是舌头运动困难，还与重建皮瓣的体积有关。我们研究了“缩下巴”姿势对术后误吸患者的影响，以改善吞咽障碍。结果显示，某些患者的误吸减少了。目前尚不清楚有效和无效之间的区别。我们建议进行透视检查以确定夹下巴的姿势是否有效。