Biomechanical Analysis of the Pharyngeal Swallow in Postsurgical Patients With Anterior Tongue and Floor of Mouth Resection and Distal Flap Reconstruction The purpose of this study was to examine changes in the biomechanics of 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 studied. Swallowing performance was assessed following a ... Research Article
Research Article  |   February 01, 1995
Biomechanical Analysis of the Pharyngeal Swallow in Postsurgical Patients With Anterior Tongue and Floor of Mouth Resection and Distal Flap Reconstruction
 
Author Affiliations & Notes
  • Barbara Roa Pauloski
    Northwestern University Evanston, IL
  • Jeri A. Logemann
    Northwestern University Evanston, IL
  • Joan Cheng Fox
    Northwestern University Evanston, IL
  • Laura A. Colangelo
    Northwestern University Evanston, IL
  • Contact author: Barbara Roa Pauloski, PhD, Northwestern University, Department of Communication Sciences and Disorders, 2299 N. Campus Drive, Evanston, IL 60208–3540.
    Contact author: Barbara Roa Pauloski, PhD, Northwestern University, Department of Communication Sciences and Disorders, 2299 N. Campus Drive, Evanston, IL 60208–3540.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Speech / Research Articles
Research Article   |   February 01, 1995
Biomechanical Analysis of the Pharyngeal Swallow in Postsurgical Patients With Anterior Tongue and Floor of Mouth Resection and Distal Flap Reconstruction
Journal of Speech, Language, and Hearing Research, February 1995, Vol. 38, 110-123. doi:10.1044/jshr.3801.110
History: Received April 13, 1994 , Accepted August 8, 1994
 
Journal of Speech, Language, and Hearing Research, February 1995, Vol. 38, 110-123. doi:10.1044/jshr.3801.110
History: Received April 13, 1994; Accepted August 8, 1994

The purpose of this study was to examine changes in the biomechanics of 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 studied. Swallowing performance was assessed following a standardized protocol with videofluoroscopy preoperatively and at 1 and 3 months postoperatively for the oral cancer patients. The normal subjects received a single videofluoroscopic study. Computer-assisted biomechanical analysis was used to mark the movements of specific oropharyngeal structures over time throughout the swallow of calibrated boluses. Statistical analyses revealed that tongue base, pharyngeal wall, hyoid, laryngeal, and cricopharyngeal movements during the swallow were altered significantly after surgery for the cancer patients. Some oropharyngeal structural movements differed from those of normal control subjects before surgery. In this study, biomechanical measures indicated that there was recovery in some aspects of the pharyngeal swallow in this patient group. The duration of tongue base to pharyngeal wall contact, which was significantly reduced preoperatively and at 1 month after surgery, increased significantly to within normal levels by the 3-month postoperative evaluation. Duration of laryngeal closure and the onset of laryngeal closure relative to cricopharyngeal opening also improved significantly to within normal levels by the 3-month postoperative evaluation.

Acknowledgments
This project was supported by NIH/NCI research grant #P01-CA40007. The authors wish to thank Masako Fujiu and Christina Smith for their assistance in data reduction; Cathy Lazarus, North-western University; Joan Kuhn, Medical College of Wisconsin; Mary Anne Heiser, Roswell Park Memorial Institute; Jan Lewin, University of Michigan; Darlene Graner, Barbara Cook, and Frank Milianti, Edward Hines V.A. Hospital, for their contributions to this study.
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