Transsurgical Palatal Obturator for Maxillectomy Patients: A Preliminary Study of Swallowing and Oropharyngeal Geometry.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Dysphagia Pub Date : 2025-05-21 DOI:10.1007/s00455-025-10831-5

Eliane Cristina Viana Revoredo, Coeli Regina Carneiro Ximenes, Thiago Freire Pinto Bezerra, Kelly Greyce Sukar Cavalcanti de Oliveira, Hilton Justino da Silva, Adriana de Oliveira Camargo Gomes, Jair Carneiro Leão

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引用次数: 0

Abstract

Introduction: Resection of malignancy through maxillectomy and subsequent maxillofacial prosthetics provides adequate swallowing function and rehabilitation. The aim of this study was to verify whether there is association between changes in swallowing and the oropharyngeal geometry in maxillectomy patients with and without using transsurgical palatal obturators (TPO).

Methods: The study includes 7 maxillectomy patients, TPO users who underwent complementary radiotherapy. Outcome variables were investigated by acoustic pharyngometry (APh) and fiberoptic endoscopic evaluation of swallowing (FEES) to assess the oropharyngeal geometry and swallowing, respectively with and without TPO. Sociodemographic and clinical characteristics (postoperative radiotherapy, type of surgery, type of obturator, time elapsed between adaptation and the swallowing test) were evaluated. To compare with and without TPO conditions, Mann-Whitney test and Spearman's correlation coefficient were used.

Results: Swallowing variables: early escape and nasopharyngeal reflux showed better results with TPO (p = 0.021 and p = 0.029, respectively) compared to swallowing without TPO. The oropharyngeal geometry was not statistically associated with swallowing changes.

Conclusion: Oropharyngeal measures by APh compared to the swallowing evaluation by FEES showed a correlation between early escape and longer length of the vocal tract in individuals with TPO. Swallowing in maxillectomy patients showed significant improvement with the use of transsurgical palatal obturator, related to the lack of early escape and absence of nasopharyngeal reflux.

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上颌切除术患者的经外科腭闭孔：吞咽和口咽几何的初步研究。

通过上颌切除术和随后的颌面修复术切除恶性肿瘤可以提供足够的吞咽功能和康复。本研究的目的是验证上颌切除术患者在使用或不使用经外科腭闭孔器（TPO）时吞咽变化与口咽几何形状之间是否存在关联。方法：对7例上颌切除术患者、TPO使用者进行辅助放疗。结果变量分别通过声学咽镜（APh）和纤维内镜吞咽评估（FEES）来评估有和没有TPO的口咽几何形状和吞咽。评估社会人口学和临床特征（术后放疗、手术类型、闭孔类型、适应和吞咽试验之间的时间间隔）。为了比较有无TPO条件，采用Mann-Whitney检验和Spearman相关系数。结果：吞咽变量：有TPO的患者早期逃逸和鼻咽反流效果优于无TPO的患者（p = 0.021和p = 0.029）。口咽几何形状与吞咽变化无统计学关联。结论：与FEES吞咽评估相比，APh口咽测量显示TPO患者早期逃逸与声道长度较长相关。上颌切除术患者使用经外科腭闭孔器后，吞咽有明显改善，这与缺乏早期逃逸和没有鼻咽反流有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dysphagia 医学-耳鼻喉科学

CiteScore

4.90

自引率

15.40%

发文量

149

审稿时长

6-12 weeks

期刊介绍： Dysphagia aims to serve as a voice for the benefit of the patient. The journal is devoted exclusively to swallowing and its disorders. The purpose of the journal is to provide a source of information to the flourishing dysphagia community. Over the past years, the field of dysphagia has grown rapidly, and the community of dysphagia researchers have galvanized with ambition to represent dysphagia patients. In addition to covering a myriad of disciplines in medicine and speech pathology, the following topics are also covered, but are not limited to: bio-engineering, deglutition, esophageal motility, immunology, and neuro-gastroenterology. The journal aims to foster a growing need for further dysphagia investigation, to disseminate knowledge through research, and to stimulate communication among interested professionals. The journal publishes original papers, technical and instrumental notes, letters to the editor, and review articles.