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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(5):877-884.
Swallowing Disorders Following Head and Neck Cancer Surgery.
Chun, Chang Sik , Choi, Kyoung Hyo , Kim, Sang Yun , Chun, Min Ho
1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine.
2Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine.
두경부 종양 환자에서 수술 후 발생하는 연하 장애
전창식, 최경효, 김상윤1, 전민호
울산대학교 의과대학 서울중앙병원 재활의학과, 1이비인후과
Abstract

Objective
This study was designed to examine swallowing function of 16 head and neck surgical patients who had postoperative swallowing difficulties and to identify the relationship between the physiologic causes of aspiration and the surgical procedure in each patient.


Method
Group A was five patients who had partial pharyngolaryngectomy due to hypopharyngeal cancer, Group B was nine patients who had wide excision due to oral cavity cancer, and Group C was two patients who had supraglottic horizontal laryngectomy due to supraglottic laryngeal cancer. Their swallowing function was evaluated with videofluoroscopic swallowing study (VFSS).


Results
Aspiration occurred in 40% of patients with partial pharyngolaryngectomy, 44% of patients with wide excision, and 100% of patients with supraglottic horizontal laryngectomy. Group A showed swallowing difficulty because of reduced laryngeal closure and reduced pharyngeal peristalsis. Group B showed swallowing difficulty because of reduced pharyngeal peristalsis, reduced laryngeal function, and impaired tongue control. Group C showed swallowing difficulty for impaired tongue control, reduced laryngeal function, reduced pharyngeal peristalsis, and late swallowing reflex. Most of the patients who had had head and neck cancer surgery can regain normal swallowing function after adequate swallowing rehabilitation.


Conclusion
Each group of head and neck surgical patients had different cause of swallowing difficulty. The knowledge of the determinant component of swallowing pathophysiology is important for successful swallowing rehabilitation.

Key Words: Swallowing disorder, Aspiration, Head and neck cancer, Videofluoroscopic swallowing study (VFSS)


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