title: Change in tongue pressure in patients with head and neck cancer after surgical resection.
abstract: Tongue pressure is reportedly associated with dysphagia. This study investigated relationships among characteristics of head and neck cancer, tongue pressure and dysphagia screening tests performed in patients with head and neck cancer during the acute phase after surgical resection. Fifty-seven patients (36 men, 21 women; age range 26-95 years) underwent surgical resection and dysphagia screening tests (Repetitive Saliva Swallowing Test, Water Swallowing Test, Modified Water Swallowing Test and Food Test) and pre- and postoperative measurement of tongue pressure at 5 time points (preoperatively, and 1-2 weeks and 1, 2, and 3 months postoperatively). Progression of cancer (stage), tracheotomy, surgical reconstruction, chemotherapy, radiotherapy and neck dissection were factors associated with postoperative tongue pressure. Data were analyzed by linear mixed-effect model, Spearman correlation coefficient and receiver operating characteristic (ROC) curve. Tongue pressure was significantly reduced 1-2 weeks after surgery, and recovered over time. Changes in tongue pressure were significantly associated with stage, radiotherapy and reconstruction. All screening tests showed a significant relationship with tongue pressure. Analysis of ROC and area under the effect curve suggested that a tongue pressure of 15 kPa can be used as a cut-off value to detect dysphagia after surgery for head and neck cancer. Our results suggest that tongue pressure evaluation might offer a safe, useful and objective tool to assess dysphagia immediately postoperatively in patients with head and neck cancer.
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan. cem17150@hyo-med.ac.jp.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Sugahara
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan.
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Fukuoka
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sakuramoto
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Horii
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Sano
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Nakao
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nanto
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Kanenori
authors.initials: K
authors.lastname: Kadoi
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Kuniyasu
authors.initials: K
authors.lastname: Moridera
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Noguchi
authors.affiliation: Department of Rehabilitation Medicine, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Domen
authors.affiliation: Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kishimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011312:Pressure; D014059:Tongue / Q000503:physiopathology*
keywords: Dysphagia; Dysphagia screening test; Head and neck cancer; Tongue pressure