Morphological changes of upper airway and dysphasia problems in oral cancer patients with oropharyngeal reconstruction surgery

Abstract

ObjectiveSwallowing statuses in patients with advanced cancers that require reconstruction have not been studied well. The relationship between topography of the reconstructed upper airway and swallowing status was evaluated. Material and methodsSubjects comprised 19 cases of tongue cancer and 10 cases of mandibular cancer who underwent resection of the primary lesion and reconstructive surgery with the vascularized free flap. CT image data preoperatively and postoperatively were utilized to evaluate morphological airway changes. Videofluorographic swallowing study (VFSS) was performed postoperatively. Aspiration and laryngeal penetration were noted and compared with morphological airway changes. ResultsRegarding postoperative airway morphology, no significant differences in postoperative airway changes were apparent between tongue and mandibular cancers. In postoperative VFSS, aspiration and/or laryngeal penetration was seen in 32% of the tongue cancer cases and 20% of the mandibular cancer cases. ConclusionCases with aspiration and/or laryngeal penetration revealed less reduction of postoperative cross-sectional area compared to other cases.