Compensatory Mechanisms in Patients After a Partial or Total Glossectomy due to Oral Cancer

Abstract Excision of a part or the whole of tongue due to oral cancer disturbs swallowing and speech. Lower airways aspiration of the swallowed bolus in patients after such oral structures excision is a symptom of major swallowing disorder and may be the cause of aspiration pneumonia. Restoration of oral nutrition is possible after exclusion or reduction of aspiration threat in the patients. Video fluoroscopic evaluation of the swallowing performed at the beginning of the swallowing rehabilitation in 95 patients after a total or partial glossectomy due to oral cancer, who assessed their saliva swallowing as efficient on the day of examination, showed disturbances of all of the swallowing stages. The most common disturbances involved the oral stage: limited mobility of the oral tongue, impaired glossopalatal seal, and weak glossopharyngeal seal. The most serious among them involved pharyngeal stage of swallowing, as leakage into the larynx and aspiration. The patients used their own methods during barium suspension swallowing to facilitate the swallowing act. They used such methods as: changing the position of the head to the body, additional swallows, engaging the adjacent structures into sealing the oral fissure. We assumed that the compensatory mechanisms (CM) worked out by the patients before the swallowing examination will enable them efficient barium suspension swallowing. The CM were applied by 71 of 95 patients; 51 of the patients used more than one c...
Source: Dysphagia - Category: Speech Therapy Source Type: research