下顎・舌・口底腫瘍術後患者の嚥下能力の回復に影響を及ぼす因子

抄録

In patients with tumor in mandibular region, the postoperative recovery process of swallowing ability might be affected by surgical resection, reconstruction, prosthetic treatment, and those effects might differ depending on postoperative days. We conducted a longitudinal analysis of possible factors that influence the swallowing ability of each postoperative stage. Swallowing ability was measured by time required to swallow 30 ml of water in 44 patients with tumor in mandibular regions before and 1, 3, 6, and 12 months after surgery. Multiple regression analysis was performed with difference between preoperative and postoperative swallowing ability of each follow-up time to identify possible factors influencing the postoperative recovery level of swallowing ability. Preoperative water-swallowing time predicted functional recovery in each follow-up time, suggesting the need to measure it preoperatively. Concerning the tumor treatment factors, neck dissection was demonstrated to decrease the recovery level of swallowing ability, but the number of occlusal support including that reconstructed by prosthetic procedures and chemotherapy were shown to increase the recovery level of swallowing ability after surgery, suggesting the efficacy of early prosthetic intervention. The study results would help in obtaining informed consent and provide efficient and farsighted rehabilitation in patients with tumor in mandibular region.