[The delay of pharyngeal phase initiation vs the course of the deglutition act in patients after partial or total tongue excision due to oral cancer].
OBJECTIVE
The coordination of the respiratory and alimentary function is indispensable to transport the food from the oral cavity to the stomach without aspiration risk. Disturbances during pharyngeal phase of swallowing, registered after oral tumour excision, are caused by diminishing of the tongue shape, decreasing of gustatory sensitivity and oral stereognosis. The aim of the work is to estimate the influence the oral tissue excision to the pharyngeal phase of deglution.


METHODS
videoradiological examination of deglutition by W.J. Dodds - for 95 patients after oral tumour excision, with swallowing disturbances. Duration of oral and pharyngeal activities, degree of realization these activities and aspiration risk were valued.


RESULTS
Abnormal mobility of tongue, lack of palato-pharyngeal and glosso-pharyngeal closure, abnormal formation of bolus accompanied to delayed initiation of pharyngeal phase. The delay of pharyngeal phase initiation was the most important for beginning and ending of the larynx closure, oesophagus opening, pharynx emptying. This delay wasn't statistically significant for duration these activities. The retention in oral cavity and in lower throat, additional deglutitions, inter-deglutition and postdeglutition leakage correlated with delay of the pharyngeal phase initiation.


CONCLUSIONS
1. The delay of pharyngeal phase initation after oral tumour excision is caused by oral swallowing disturbances. 2. The delay of pharyngeal phase initiation after oral tumor excision is dependent on the range of surgery and reconstruction. 3. The delay of pharyngeal phase initiation after oral tumour excision is important for beginning and ending of the pharyngeal phase activities, it isn't important for their duration. 4. The deficit of oral sensory stimuli causes desynchronization of the pharyngeal phase activities and diminishes the swallowing efficiency. 5. Improvement of the swallowing efficiency after partial or total tongue excision is possible by oral phase elongation, by monitoring of the swallowing apnea and by multiple deglutitions.
Halczy-Kowalik
Ludmiła
L
Samodzielna Pracownia Rehabilitacji Pooperacyjnej Chirurgii Szczekowo-Twarzowej Pomorskiej Akademii Medycznej al. Powstańców Wlkp. 72, 70-111 Szczecin.
Wysocki
Rościsław
R
Posio
Violetta
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D001259:Ataxia; D002648:Child; D002933:Cineradiography / Q000379:methods; D003679:Deglutition; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D005683:Gagging / Q000502:physiology; D005927:Glossectomy / Q000009:adverse effects* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D011183:Postoperative Complications; D015656:Respiratory Mechanics; D013997:Time Factors; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery; D016896:Treatment Outcome