Abstract
Maintaining function after complete tumor resection and improved prognosis are important in patients with head and neck cancer. We assessed articulation and swallowing after radical surgery and reconstruction in 25 patients with advanced tongue cancer. Articulation was assessed based on General Rules for Clinical Studies on Head and Neck Cancer of the Japan Society for Head and Neck Cancer. Swallowing was assessed based on Method of intake, Time of intake, and Food (MTF) scores proposed by Fujimoto et al. Results showed articulation to be significantly impaired in those whose lingual apex was removed. Swallowing became worse in those with greater lingual root removal. Specifically, those with less than 50% of the lingual root resected consumed soft or normal foods easily. Two of the eight subjects with more than 50% of lingual root resected together with subtotal glossectomy or hemiglossectomy could not take any foods due to swallowing difficulty. Their swallowing was evaluated using videoendscopy (VE) and videofluorography (VF), based on which, cricopharyngeal myotomy and laryngeal suspension were conducted, enabling them to consume soft foods. Results thus confirmed the importance of evaluating swallowing difficulty postoperatively using VE and VF, and of the role of revised surgery in recovering swallowing function. Our clinical experience suggests that cricopharyngeal myotomy and laryngeal suspension should be done simultaneously with 50% lingual root resection.
