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Change in tongue pressure in patients with head and neck cancer after surgical resection

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Abstract

Tongue pressure is reportedly associated with dysphagia. This study investigated relationships among characteristics of head and neck cancer, tongue pressure and dysphagia screening tests performed in patients with head and neck cancer during the acute phase after surgical resection. Fifty-seven patients (36 men, 21 women; age range 26–95 years) underwent surgical resection and dysphagia screening tests (Repetitive Saliva Swallowing Test, Water Swallowing Test, Modified Water Swallowing Test and Food Test) and pre- and postoperative measurement of tongue pressure at 5 time points (preoperatively, and 1–2 weeks and 1, 2, and 3 months postoperatively). Progression of cancer (stage), tracheotomy, surgical reconstruction, chemotherapy, radiotherapy and neck dissection were factors associated with postoperative tongue pressure. Data were analyzed by linear mixed-effect model, Spearman correlation coefficient and receiver operating characteristic (ROC) curve. Tongue pressure was significantly reduced 1–2 weeks after surgery, and recovered over time. Changes in tongue pressure were significantly associated with stage, radiotherapy and reconstruction. All screening tests showed a significant relationship with tongue pressure. Analysis of ROC and area under the effect curve suggested that a tongue pressure of 15 kPa can be used as a cut-off value to detect dysphagia after surgery for head and neck cancer. Our results suggest that tongue pressure evaluation might offer a safe, useful and objective tool to assess dysphagia immediately postoperatively in patients with head and neck cancer.

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Acknowledgements

This study was supported by a grant from the Ministry of Education, Science and Culture of Japan (No. 25463043). The authors declare no conflicts of interest with any financial organization regarding the manuscript. The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would like to express their sincere appreciation to K. Yoshikiyo and M. Shiramizu for their tremendous support.

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Authors and Affiliations

  1. Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya City, Hyogo, 663-8501, Japan

    Yoko Hasegawa, Kazuma Sugahara, Ayumi Sakuramoto, Nobuhide Horii, Saori Sano, Kana Hasegawa, Kanenori Kadoi, Kuniyasu Moridera, Kazuma Noguchi & Hiromitsu Kishimoto

  2. Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Hyogo, Japan

    Tatsuyuki Fukuoka, Shota Saito, Yuta Nakao & Tomoki Nanto

  3. Department of Rehabilitation Medicine, Hyogo College of Medicine, Hyogo, Japan

    Kazuhisa Domen

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  1. Yoko Hasegawa
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Correspondence to Yoko Hasegawa.

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Kazuma Sugahara: Co-first author.

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Hasegawa, Y., Sugahara, K., Fukuoka, T. et al. Change in tongue pressure in patients with head and neck cancer after surgical resection. Odontology 105, 494–503 (2017). https://doi.org/10.1007/s10266-016-0291-0

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  • DOI: https://doi.org/10.1007/s10266-016-0291-0

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