Increased Postoperative Posterior Pharyngeal Wall Movement in Patients With Anterior Oral Cancer

Abstract

Anterior bulging of the posterior pharyngeal wall (PPW) and its contact with the base of the tongue (BOT) is an essential element of the pharyngeal stage of swallowing. Postoperative changes in the extent of anterior bulge of the PPW during the pharyngeal swallow were documented in 11 oral cancer patients who underwent surgical resections of the anterior tongue and/or floor of the mouth. Seven subjects demonstrated approximately a 30% or more increase in anterior bulge of the PPW during liquid and/or paste swallows at 3 months postoperatively relative to their preoperative values. The other four subjects demonstrated no change or a decrease in anterior bulge of the PPW postoperatively. No notable increase or decrease in anterior bulge of the PPW was observed between the 3- and 6-month postoperative evaluations of the six subjects whose 6-month post-operative data were available. PPW bulge tended to increase more in subjects with poor oropharyngeal swallow efficiency, which was likely to be related to greater extent of tongue resection. These results suggest the potential for compensatory movement of the PPW when the BOT is positioned more anteriorly, and a possible treatment approach to increasing PPW contraction in dysphagic individuals with reduced BOT-to-PPW contact during the pharyngeal swallow.