Abstract
PurposeThe purpose of this study was to observe the impact of oral oncological treatment, including the recovery of several tongue functions (force, mobility, and sensory functions), and to determine the influence of these functions on masticatory performance.Materials and methodsMasticatory performance and tongue force, mobility, and sensory functions were determined in 123 patients with oral cavity cancer. The assessments were performed 4 weeks before treatment and 4 to 6 weeks, 6 months, 1 year, and 5 years after treatment. Generalized estimation equations and mixed model analyses were performed, correcting for previously identified factors in the same population.ResultsA significant deterioration in tongue mobility and sensory function was observed in patients with mandible and tongue and/or floor-of-mouth tumors. Better tongue force and sensory function (thermal and tactile) positively influenced masticatory performance, and this effect was stronger where fewer occlusal units were present. The effect of both the tongue force and maximum bite force was weaker in dentate patients in comparison with patients with full dentures. A web-based application was developed to enable readers to explore our results and provide insight into the coherence between the found factors in the mixed model.ConclusionsTongue function deteriorates after oral oncological treatment, without statistically significant recovery. Adequate bite and tongue forces are especially important for patients with a poor prosthetic state. Patients with sensory tongue function deficits especially benefit from the presence of more occluding pairs.
Highlights
Mastication is a coordinated process, integrating central control, sensory input, and muscle function
Before we can understand the importance of tongue function for the masticatory performance of patients confronted with oral cancer, tongue function must be quantitatively evaluated over time. The purpose of this prospective cohort study was to observe the longitudinal results of tongue mobility (TM), sensory function, and tongue force in patients treated for oral cancer
The three location groups differed in their mean age, T-stage of the primary tumor, and baseline Mixing Ability Index (MAI) and maximum mouth opening (MMO) values (p = 0.036, p = 0.014, p = 0.021, and p < 0.001, respectively)
Summary
Mastication is a coordinated process, integrating central control, sensory input, and muscle function. Food is introduced to the mouth in bite-sized pieces, positioned on the occlusal surfaces by the cheek and tongue, and pulverized by chewing. It is collected in the oropharynx to form a bolus, ready for swallowing [1]. Both sensory tongue function for food bolus allocation and motor function for food bolus transportation are essential for effective masticatory performance [2]. For example, the laterodeviation to the left of the tongue is impeded, mastication on that side can be impaired by the hampered transportation of food to the occlusal surfaces [3]. Factors influencing masticatory performance in patients with oral cancer are their maximum bite force (MBF), maximum mouth opening (MMO), tumor
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