1988 Volume 28 Issue 4 Pages 496-505
Swallowing disorder is one of the most serious dysfunctions followed by the maxillectomy. The purpose of this study is to elucidate the changes of swallowing process after operation using 35m/m cineradiography.
The patient was 36-year-old male who received a right total hemimaxillectomy because of malignant fibrous histiocytoma. Lateral and posteroanterior cineradiographs were taken during the swallowing of barium sulphate solution as the bolus. This cineradiographic examination was done periodically (before operation, in 3, 6 and 9 months after operation). The movements of oral structures, the tongue posture at the time point that the contrast medium reached the lower margin of mandible and transit time during oral and pharyngeal stages of swallowing were analyzed by using the cinefilm analyzer varying speed of the film.
In 3 months after operation, maintenance and passage of contrast medium deviated from the midline of tongue toward normal side. And the medium was swallowed little by little in oral stage. Consequently, overall transit time time became prolonged.
In 6 and 9 months, depression of tongue just after the start of swallowing became increased. As a result of increased tongue depression, passage of contrast medium was able to be done again on the midline of tongue and the contrast medium flowed down to vallecula as if water fall by the aid of gravity. Thus, timing of swallowing became closer to that of before operation.
From this study, it was suggested that alteration of tongue behavior, especially tongue depression, had an important role which might compensate the swallowing disorders following maxillectomy.
