Nasycenie krwi obwodowej tlenem i tętno podczas przełykania u pacjentów z nowotworem jamy ustnej oraz po jego wycięciu

Abstract

Background. Breath holding during swallowing enables safe transport of bolus from the oral cavity to the esophagus without threat of aspiration into the lower airways. Inter-deglutition apnea elongation needed for the performance of several swallows supporting non-efficient lower pharynx emptying in the patients after oral cavity neoplasm excision, may be the cause of the peripheral blood saturation decrease.Objectives. The aim of the study was to assess peripheral blood saturation during swallowing in patients with oral cavity neoplasm and after its excision.Material and Methods. One hundred fifty-six patients with oral cavity neoplasm were scheduled for surgical treatment. Pulse oximetry was performed before surgery, and 2 and 4 weeks post-surgically. Video fluoroscopic swallowing examination was performed 2 and 4 weeks post-surgically, simultaneously with pulse oximetry.Results. After neoplasm excision, desaturation was indicated by time percentage of saturation lower than 95% increase and pulse rate acceleration. We recorded improved saturation 4 weeks after surgery and after the rehabilitation of swallowing; there was an increase in the lowest saturation value and a decrease in time percentage of saturation lower than 95%. Post-deglutition retention correlated most with the saturation. Time percentage of saturation lower than 95% for post-deglutition retention was a sensitive test in 82%, and a specific test in 70%.Conclusion. The course of act swallowing improves in patients subjected to swallowing rehabilitation after oral cavity neoplasm excision as time passes by after surgery. Desaturation during swallowing in patients after oral cavity excision improves as time passes by in patients subjected to swallowing rehabilitation. Post-deglutition retention indicating that inefficient swallowing and aspiration threat are present is a feature of disturbed swallowing act which correlates the most with desaturation, especially with time percentage of saturation lower than 95%.