구강 및 하인두암 수술 후 발생하는 연하장애
Dysphagia after Oral Cavity and Hypopharyngeal Cancer Surgery
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Dysphagia is an important symptom of head and neck cancer, as well as representing a significant complication of its treatment. Surgical interventions for cancers of the head and neck result in specific anatomic or neurologic insults with site-specific patterns of dysphagia and aspiration. Extirpation of cancers of the oral cavity can create complex swallowing disorders that involve both the oral and pharyngeal stages. Tongue mobility is the most critical component of swallowing initiation and to the subsequent triggering of the pharyngeal stage. In general, resections that preserve neural innervation combined with reconstructions that allow optimal residual tongue movement will result in the best swallowing outcome. Hypopharynx shares a wall with the larynx, and the larynx is therefore usually sacrificed during surgery in the advanced case of hypopharyngeal cancer. The degree of functional deficit following hypopharyngectomy is dependent upon the extent of resection. This article reviews the effect of the various surgical treatment for the oral cavity and hypopharyngeal cancer on the swallowing mechanism. (JKDS 2013;3:7-9)
Abstract
Dysphagia is an important symptom of head and neck cancer, as well as representing a significant complication of its treatment. Surgical interventions for cancers of the head and neck result in specific anatomic or neurologic insults with site-specific patterns of dysphagia and aspiration. Extirpation of cancers of the oral cavity can create complex swallowing disorders that involve both the oral and pharyngeal stages. Tongue mobility is the most critical component of swallowing initiation and to the subsequent triggering of the pharyngeal stage. In general, resections that preserve neural innervation combined with reconstructions that allow optimal residual tongue movement will result in the best swallowing outcome. Hypopharynx shares a wall with the larynx, and the larynx is therefore usually sacrificed during surgery in the advanced case of hypopharyngeal cancer. The degree of functional deficit following hypopharyngectomy is dependent upon the extent of resection. This article reviews the effect of the various surgical treatment for the oral cavity and hypopharyngeal cancer on the swallowing mechanism. (JKDS 2013;3:7-9)
참고문헌 (3)
- Manikantan K, "Dysphagia in head and neck cancer", Cancer Treatment Reviews, 35, pp.724~732 (2009)
- Sulica L, "Botulinium toxin treatment of upper esophageal sphincter hyperfunction", Operative Techniques in Otolaryngology-Head and Neck Surgery, 15, pp.107~109 (2004)
- Moerman MB, "Cricopharyngeal botox injection : indications and technique", Curr Opin Otolaryngol Head Neck Surg, 14, pp.431~436 (2006)