Evaluation of swallowing ability using swallowing sounds in maxillectomy patients

Abstract

Maxillectomy for oral tumors often results in debilitating oral hypofunction, which markedly decreases quality of life. Dysphagia, in particular, is one of the most serious problems following maxillectomy. This study used swallowing sounds as a simple evaluation method to evaluate swallowing ability in maxillectomy patients with and without their obturator prosthesis placed. Twenty-seven maxillectomy patients (15 men, 12 women; mean age 66.0±12.1 years) and 30 healthy controls (14 men, 16 women; mean age 44.9±21.3 years) were recruited for this study. Participants were asked to swallow 4 mL of water and swallowing sounds were recorded using a throat microphone. Duration of the acoustic signal and duration of peak intensity (DPI) were measured. DPI was significantly longer in maxillectomy patients without their obturator than with it (p<0.05) and was significantly longer in maxillectomy patients without their obturator than in healthy controls (p<0.025 after Bonferroni correction). With the obturator placed, DPI was significantly longer in maxillectomy patients who had undergone soft palate resection than in those who had not (p<0.05). These results suggest swallowing ability in maxillectomy patients could be improved by wearing an obturator prosthesis, particularly during the oral stage. However, it is difficult to improve the oral stage of swallowing in patients who have undergone soft palate resection even with obturator placement.

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