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Video fluoroscopic evaluation after glossectomy.

C L Furia1, E Carrara-de Angelis, N M Martins

  • 1Department of Voice, Speech, and Swallowing Rehabilitation, Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo, São Paulo, Brazil.

Archives of Otolaryngology--Head & Neck Surgery
|March 18, 2000
PubMed
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Swallowing function after glossectomy varies by resection extent, with all patients showing increased oral transit time. Rehabilitation effectively manages dysphagia, with only minor persistent aspiration in some total glossectomy cases.

Area of Science:

  • Otolaryngology
  • Speech and Language Pathology
  • Surgical Oncology

Background:

  • Swallowing deficits (dysphagia) are common after oral or oropharyngeal resections, varying with resection site, extent, and reconstruction method.
  • Glossectomy, specifically, often leads to significant swallowing difficulties, impacting oral bolus manipulation and propulsion.
  • Voice and speech impairments frequently accompany glossectomy due to tongue removal.

Purpose of the Study:

  • To characterize swallowing function in patients following glossectomy.
  • To identify the limitations and compensatory movements during swallowing using video fluoroscopic analysis.
  • To evaluate the impact of glossectomy extent on swallowing performance.

Main Methods:

  • Video fluoroscopic evaluation of 15 patients who underwent partial, subtotal, or total glossectomy.

Related Experiment Videos

  • Patients were categorized based on the extent of glossectomy and type of reconstruction (e.g., myocutaneous flaps).
  • All participants were enrolled in a comprehensive voice, speech, and swallowing rehabilitation program.
  • Main Results:

    • Partial glossectomy patients experienced difficulties in bolus formation and oral propulsion, with increased oral transit time, especially for thicker consistencies.
    • Total and subtotal glossectomy patients showed increased oral transit time and residue in the oral cavity, pharynx, and upper esophagus.
    • Two patients (total glossectomy) exhibited moderate, asymptomatic aspiration, employing significant compensatory swallowing strategies.

    Conclusions:

    • Swallowing rehabilitation is effective for patients undergoing partial or total glossectomy.
    • Increased oral transit time is a consistent finding across all glossectomy extents.
    • Persistent asymptomatic aspiration was minimal, observed in only 2 of 10 total glossectomy patients.