Manofluorography of Swallowing in Glossectomy Patients with the PAP

Abstract

Patients with tongue cancer who have undergone surgical resection often develop swallowing disorder due to lack of tongue mobility and sensibility．The palatal augmentative prosthesis，or PAP， is a tool for prosthodontic management of glossectomy patients，seeking to improve tongue/palate contact during speech and swallowing．Recent study suggested that the presence of an intraoral prosthesis not only increases tongue contact to the palate or pseudoplate but also provides a better oral anchor point against which the base of the tongue can function．The purpose of this study is to examine pharyngeal manofluorography to evaluate the effect of the PAP for glossectomy patients．

A subject，who had undergone resection of the hemi lateral tongue，used a PAP， seeking to improve swallowing function．Under conditions of both with and without the PAP，the pressures of the areas of the tongue base and the low hypopharynx，the duration of the base of tongue/pharyngeal posterior wall contacts and pharyngeal transit time were obtained using manofluorography．

With insertion of the PAP， the pressure in the low hypopharynx was significantly lower， the duration of tongue base/pharyngeal posterior wall contacts was slightly longer，and pharyngeal transit time was significantly shorter．

The wave of the pressure observed in the area of the low hypopharynx is termed the C-wave，which the pharyngeal constrictors are responsible for．The higher C-wave without the PAP suggested that pharyngeal posterior wall contraction compensated for the lack of tongue base force projected to the bolus for propulsion．With the PAP，a better oral anchor point，against which the base of the tongue can function，might provide driving force and relieve the activity of the pharyngeal posterior wall．