umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Intraoral sensation before and after radiotherapy and surgery for oral and pharyngeal cancer.
Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Radiology.
2004 (English)In: Head and Neck, ISSN 1043-3074, E-ISSN 1097-0347, Vol. 26, no 11, 923-929 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with unilateral oral or pharyngeal cancer often receive bilateral radiotherapy because of the potential for metastases. Because postoperative sequelae are evident on the tumor side, to date little attention has been paid to sensory alterations after radiotherapy on the healthy, nontumor side. The objective of this study was to investigate possible sensory alterations. METHODS: Intraoral sensation was tested bilaterally at standardized sites in 27 patients and 20 controls. Preoperative radiotherapy was bilateral in 19 patients and unilateral in eight patients. Patients were tested before treatment, after radiotherapy, and after surgery at 6 months and 1 year. Comparisons were performed interindividually and intraindividually and between groups. RESULTS: A delayed deterioration of sensation was revealed on the nontumor side 6 months after radiotherapy. There was no recovery 1 year after treatment. CONCLUSIONS: Intraoral sensation cannot be evaluated directly after radiotherapy. It is plausible that sensory deterioration after radiotherapy has an impact on functional rehabilitation after tumor treatment.

Place, publisher, year, edition, pages
2004. Vol. 26, no 11, 923-929 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-16015DOI: 10.1002/hed.20077PubMedID: 15386598OAI: oai:DiVA.org:umu-16015DiVA: diva2:155688
Available from: 2008-01-31 Created: 2008-01-31 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Impairment of intra-oral sensation, discrimination ability, and swallowing function following radiotherapy and surgery for oral and pharyngeal cancer
Open this publication in new window or tab >>Impairment of intra-oral sensation, discrimination ability, and swallowing function following radiotherapy and surgery for oral and pharyngeal cancer
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Oral and pharyngeal cancer is commonly treated with a combination of radiotherapy and surgery. It is a clinical knowledge that patients often experience severe swallowing disorders following treatment. Since surgical sequelae are instantaneous and obvious, little attention has been paid to other concurrent effects of the treatment. To shed light on this subject, the aim of this thesis was twofold (i) to make a retrospective inventory of the sequelae following treatment and (ii) to perform a prospective, inceptive examination at diagnosis, and to follow-up after radiotherapy, six months and 12 months after surgery.

The files of ninety-nine patients revealed that following treatment one-third had to use gastric fistulas and more than nine of ten patients had restricted swallowing capacity. Every second patient could only swallow puréed or liquid food.

Adequate intra-oral sensation and discrimination ability is essential for bolus preparation and bolus control, for appropriate elicitation of the swallowing reflex and, hence, for the oral phase of swallowing. At the inceptive examination, the prospective part of the study demonstrated intra-oral discrimination ability in patients was equal to that in healthy controls but was impaired six months after treatment and there was no significant improvement after 12 months. It had been expected that the patient’s healthy, non-tumor side would compensate but it did not. An explanation was found when it was revealed that radiotherapy induced a delayed decline in intra-oral sensation. Sensory decline was not demonstrated within a month after radiotherapy but was manifest six months later. Since the radiotherapy field includes the neck, because of the risk for metastasis, it is highly plausible that pharyngeal sensation declines in a manner corresponding to that found intra-orally when the healthy side is irradiated. In accord with this presumption, pharyngeal swallowing function deteriorated in patents with oral tumors. Cineradiographic evaluation of oral and pharyngeal swallowing function disclosed a significant association between the degree of swallowing dysfunction and the degree of sensory decline and with the degree of impairment of shape recognition.

Conclusions: Delayed intra-oral sensory decline, found to be induced by radiotherapy, can be expected to appear in the entire radiation field, including the oral cavity and the pharynx, with adverse effect on swallowing. Testing intra-oral sensation close to the last radiotherapy session is not advisable, because sensory decline does not develop immediately after radiotherapy but manifests after six months. Spontaneous sensory rehabilitation cannot be expected after six months. The significant association between degree of swallowing dysfunction and degree of intra-oral sensory decline and impaired discrimination ability must be considered in the quest for functional rehabilitation of patients treated for oral or pharyngeal cancer.

Publisher
112 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 85
Keyword
Medical sciences, Oral cancer, pharyngeal cancer, radiotherapy, surgery, intra-oral sensation, sensibility, swallowing, intra-oral discrimination, deglutition disorders, dysphagia, function, dysfunction, radiography, cineradiography, follow-up, MEDICIN OCH VÅRD
National Category
Medical and Health Sciences
Research subject
Diagnostic Radiology
Identifiers
urn:nbn:se:umu:diva-266 (URN)91-7305-651-0 (ISBN)
Public defence
2004-06-02, 260, 3A, Norrlands Universitetssjukhus, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2004-05-07 Created: 2004-05-07 Last updated: 2010-02-24Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Levring Jäghagen, EvaIsberg, Annika
By organisation
Oral and Maxillofacial Radiology
In the same journal
Head and Neck
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 643 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf