OP076: Videoflouroscopic evaluation of swallowing after glossectomy – A prospective study

Abstract

Purpose The swallowing deficits that result from oral or oropharyngeal resections vary considerably depending on the site, extension of the resection, and type of reconstruction. Most patients will experience some degree of dysphagia despite the reconstructive effort. The purpose of this study was to characterize swallowing dysfunction in patients who underwent a glossectomy with flap reconstruction, to define the limits and the compensatory movements using video fluoroscopic analysis of swallowing (VFS). Methodology A prospective evaluation of 16 glossectomy patients (15 men and 1 women), aged 40–60 years, who underwent glossectomy with flap reconstruction were volunteers. Videoflouroscopic swallowing study (VFS) was carried out after a preliminary subjective evaluation. Recordings were analysed and a comparison of the swallowing dysfunctions were made. During the videoflouroscopic recordings, the effectiveness of different compensatory and rehabilitative swallowing therapy techniques was tried. Results Patients who underwent a total glossectomy with laryngeal preservation had an increase in oral transit time and stasis of food in the oral cavity, the pharynx. Patients who underwent a partial glossectomy (lateral border of tongue involvement only) had difficulties with formation and antero-posterior propulsion of the bolus in the oral cavity. The stasis in the oral cavity/valleculae and oral transit delay was comparatively less, and was evident only with materials of thicker consistencies. All patients benefited from rehabilitative and compensatory swallowing manoeuvres. Conclusions Videofluoroscopic analysis of swallowing could characterize swallowing dysfunction in patients who underwent a glossectomy with flap reconstruction. Videoflouroscopic analysis of swallowing is not only a mere diagnostic tool but also a prognostic tool. Appropriate swallowing intervention benefited the patients in regaining the swallowing function. Patients with total glossectomy (with involvement of base tongue) showed longer time for recovery than partial glossectomy patients.