Departmental Bulletin Paper 〈Originals〉Swallowing function in patients who underwent after subtotal glossectomy and reconstruction with a rectus abdominis musculocutaneous flap

Matsunaga, Kazuhide  ,  Kusuhara, Hirohisa  ,  Enomoto, Akifumi  ,  Mori Kazunori  ,  Kitano, Mutsukazu  ,  Mukai, Takao  ,  Shimoide, Takeshi  ,  Doi Katsumi  ,  IsogaiNoritaka  ,  Hamada, Suguru

[Abstract]Purpose: Swallowing function was evaluated 3 years after surgery in three tongue cancer patients who underwent bilateral total neck dissection and subtotal glossectomy with reconstruction using a rectus abdominis musculocutaneous flap. Materials and Methods: The morphology of the flap and swallowing function were evaluated. Swallowing function was assessed by video fluorography with a 10 ml test diet. The items for evaluation of swallowing were: (1) holding the test diet in the oral cavity, (2) epiglottis turnover, (3) aspiration, (4) hyoid bone movement, and (5) maximum width of the esophageal entrance. Results: With regard to flap morphology, two patients had a protuberant flap and one had a semi-protuberant flap. One patient was able to hold the test diet in the oral cavity, while slight flow of the test diet into the pharynx was observed in the other 2 patients. Epiglottis turnover was good in one patient, but was insufficient in two patients. Aspiration was not observed in any of the patients. The hyoid bone moved forward and upward in all three patients. The maximum width of the esophageal entrance was good in all patients. Conclusions: Elevation of the hyoid bone was demonstrated in all three patients, even though almost all of the bilateral suprahyoid muscles had been resected with the exception of stylohyoid. For good postoperative swallowing function and hyoid bone movement after subtotal glossectomy, it is necessary to perform reconstruction with a flap that has sufficient volume and to retain the bilateral stylohyoid muscles.

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