BIOMECHANICAL ANALYSIS OF THE PHARYNGEAL SWALLOW IN POSTSURGICAL PATIENTS WITH ANTERIOR TONGUE AND FLOOR OF MOUTH RESECTION AND DISTAL FLAPRECONSTRUCTION

The purpose of this study was to examine changes in the biomechanics o f pharyngeal swallow after surgery in eight patients (six men and two women) with anterior tongue and floor of mouth resections with distal flap reconstruction. Eight normal age-matched subjects were also studi ed. Swallowing performance was assessed following a standardized proto col with videofluoroscopy preoperatively and at 1 and 3 months postope ratively for the oral cancer patients. The normal subjects received a single videofluoroscopic study. Computer-assisted biomechanical analys is was used to mark the movements of specific oropharyngeal structures over time throughout the swallow of calibrated boluses. Statistical a nalyses revealed that tongue base, pharyngeal wall, hyoid, laryngeal, and cricopharyngeal movements during the swallow were altered signific antly after surgery for the cancer patients. Some oropharyngeal struct ural movements differed from those of normal control subjects before s urgery. In this study, biomechanical measures indicated that there was recovery in some aspects of the pharyngeal swallow in this patient gr oup. The duration of tongue base to pharyngeal wall contact, which was significantly reduced preoperatively and at 1 month after surgery, in creased significantly to within normal levels by the 3-month postopera tive evaluation. Duration of laryngeal closure and the onset of laryng eal closure relative to cricopharyngeal opening also improved signific antly to within normal levels by the 3-month postoperative evaluation.