Dynamics of Swallowing Tablets during the Recovery Period following Surgery for Tongue Cancer

Abstract

Objective: Medicinal tablets are sometimes difficult to swallow, even for healthy individuals. Accordingly, it is likely more difficult for patients to swallow tablets after oral surgery for tongue tumors. In this study, we aimed to investigate the dynamics of swallowing tablets in the recovery period following surgery for tongue tumors. Methods:Two experiments were conducted (Experiment 1 and Experiment 2). In Experiment 1, 20 tongue cancer patients swallowed simulated tablets and underwent videofluoroscopic (VF) examination of swallowing before and after surgery. The ability or inability to pass the tablet to the esophagus and the number of swallowing attempts required to ingest the tablet were evaluated. In Experiment 2, 48 similar subjects swallowed thickened barium and simulated tablets and underwent VF examination of swallowing after surgery. The ability or inability to pass the tablet to the esophagus, the number of swallows required to ingest the tablet, the tablet position after the initial and the final swallowing reflexes, and the oral transit time and pharyngeal transit time for swallowing the thickened barium solution and simulated tablets were evaluated.Results: After subtotal glossectomy, more subjects were unable to pass the tablet to the esophagus after surgery rather than before surgery. However, after surgery, patients needed more numbers of swallowing reflex attempts in order to successfully swallow tablets. Also, the tablets remained not only in the mouth, but also in the epiglottic vallecula and pyriform sinus. In the patients who could pass the tablet, the oral transit time of the thickened barium solution was shorter than in the patients who could not. Conclusion:In cases of subtotal glossectomy, tablet intake should be avoided, particularly in the recovery phase, and VF or endoscopic evaluation of swallowing should be performed when tablets are prescribed. After tongue cancer surgery, patients should be recommended to make multiple swallowing attempts when swallowing tablets.