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阐明癌症治疗对舌癌患者吞咽模式的影响。对比放疗前后吞咽情况，发现放疗后咽延迟时间延长（定义为中头在下颌骨后支处至咽部吞咽触发所花费的时间，即喉部抬高），中容积越小越倾向于增强这一现象。部分患者在吞咽后出现吞咽障碍，如过早吞咽、喉部穿透、口腔、小静脉及食道入口有少许残留。这些发现表明，饮酒可能会增加吞咽障碍的风险。术后舌部切除及放疗后重建的吞咽情况对比显示造影剂失去控制，吞咽分裂，术后志向及口腔、小囊及食道入口残留。除了这些特性外，我们还观察到时间变化，如口腔传递时间延长，咽传递时间延长，咽延迟时间延长。部分皮瓣较小的患者表现出较严重的吞咽障碍。因此，吞咽障碍可能不仅是由于舌头运动困难，而且与重建皮瓣的体积有关。我们研究了“收下巴”姿势对术后误吸患者的影响，以改善吞咽障碍。结果显示，在一些患者中，减少了误吸。目前还不清楚有效和无效之间的区别。我们建议用透视检查来确定收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.