A Movement Analysis of Hyoid Bone for Postoperative Tongue Cancer

Ryuta Osaka DDS, Dentistry/Oral Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Masataka Shiozaki MD, Plastic and Reconstructive Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Ikuhiro Uchida DDS, PhD, Dentistry/Oral Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Sadao Ohyama DDS, Dentistry/Oral Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Chiharu Ogawa DDS, Dentistry/Oral Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Tomoya Soma DDS, Dentistry/Oral Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Yasunobu Terao MD, PhD, Plastic and Reconstructive Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
Takahiko Shibahara DDS, PhD, Tokyo Dental College, Tokyo, Japan

Objectives

The hyoid bone is an important contributor to swallowing, and numerous reports demonstrate the effect of its "movement distance" and "speed" on pulmonary aspiration. Motor impairment of the hyoid bone can occur following oral tumor resection, and postoperative dysphagia is common. However, there are no present reports thoroughly analyzing hyoid bone movement in patients who underwent reconstructive surgery after oral tumor resection.

In this study, we investigated hyoid bone's movement distance using videofluorography(VF) and 2-dimensional data analysis in patients who underwent reconstructive surgery after oral tumor resection.

Materials and Methods

From 2004 to 2013, thirty-three patients (24 male; 9 female; mean age 60.1 years) with tongue squamous cell carcinoma who underwent resection and reconstructive surgery at Komagome Hospital were evaluated. Sixteen patients underwent hemiglossectomy; 11 underwent subtotal glossectomy; and 6 underwent total glossectomy. Tongue reconstructive techniques included RAMc flap in 23 patients, Radial forearm flap in 6 patients, ALT flap and other in 2 patients each. Three patients underwent laryngeal suspension, Cricopharyngeal myotomy was not performed on any patient.

We analyzed the VF images using 2-dimensional data analysis software (Dipp-Motion Pro2D Ver2.23b, Ditect Co. Ltd.). The vertebrae served as the XY axis; after scale correction, we automatically tracked hyoid bone movement during swallowing on the coordinate system. Vertical distance, anteroposterior distance, and the resting position were compared to normal control.

Results

Although in the most of cases, vertical and anteroposterior movement of the hyoid bone was generally preserved, the pattern of hyoid bone's movement was not smooth.

In the long-term following cases, the hyoid bone described a trajectory similar to normal control. And their swallowing function showed the improvement tendency.

Conclusions

In this study, we discussed swallowing using 2-dimensional data analysis software to enable simple and convenient quantitative analysis clinically. As a result, we were able to objectively visualize and assess dysphagia in patients after surgical resection. Future studies will assess more patients and analyze dysphagia long term according to the extent of surgery and reconstructive approach.

References

Ishida R, Palmer JB, Hiiemae KM: Hyoid motion during swallowing: Factors affecting forward and upward displace­ ment, Dysphagia, 17: 262-272, 2002.

Wang TG, Chang YC, Chen WS, et al: Reduction in hyoid bone forward movement in irradiated nasopharyngeal carcinoma patients with dysphagia, Arch Phys Med Rehabil, 91:926- 931, 2010.

See more of: Poster Session
See more of: Abstract/Poster Sessions
<< Previous Abstract | Next Abstract >>