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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Radiotherapy thought vital in treating head and neck cancer, occasionally causes seriously local complications such as mandibular osteoradionecrosis (ORN). An analysis of mandibular ORN cases showed 16 in 638 subjects treated by radiotherapy, for an ORN rate of 2.5%. This rate was highest in subjects with oral cancer excluding the tongue, administered 81 Gy radiation dose, using X-ray plus electronic beams. 8 cases of ORN occurred within 1 year following radiation, and the 8 others within 5 years. Preservation treatment was successful in 44% of ORN cases, including surgery, for which the rate of final cure was 63%. With case of cancer recurrence, the rate was 25%. In 2 subjects dying of aspiration pneumonia, the cause should be a particular point for reflection. Radiotherapy involving mandibular bone should include special consideration related to the radiation source, radiation dose. Once ORN occurred, we should take care of the mixed cancer and dysphagia in the treatment.
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PMID:[Clinical analysis of mandibular osteoradionecrosis]. 2140 17

Excision of a part or the whole of tongue due to oral cancer disturbs swallowing and speech. Lower airways aspiration of the swallowed bolus in patients after such oral structures excision is a symptom of major swallowing disorder and may be the cause of aspiration pneumonia. Restoration of oral nutrition is possible after exclusion or reduction of aspiration threat in the patients. Video fluoroscopic evaluation of the swallowing performed at the beginning of the swallowing rehabilitation in 95 patients after a total or partial glossectomy due to oral cancer, who assessed their saliva swallowing as efficient on the day of examination, showed disturbances of all of the swallowing stages. The most common disturbances involved the oral stage: limited mobility of the oral tongue, impaired glossopalatal seal, and weak glossopharyngeal seal. The most serious among them involved pharyngeal stage of swallowing, as leakage into the larynx and aspiration. The patients used their own methods during barium suspension swallowing to facilitate the swallowing act. They used such methods as: changing the position of the head to the body, additional swallows, engaging the adjacent structures into sealing the oral fissure. We assumed that the compensatory mechanisms (CM) worked out by the patients before the swallowing examination will enable them efficient barium suspension swallowing. The CM were applied by 71 of 95 patients; 51 of the patients used more than one compensatory mechanism. Swallowing in 61 of the compensating patients was at least functional; swallowing in 10 of the compensating patients was non-efficient and caused recurrent aspiration. The results of our research negate the validity of multiple swallows (more than three) without apnea elongation because it may lead to aspiration. Aspiration was also recorded in patients with weak airways closure and immovable epiglottis, who complemented the impaired oral transport with gravitational oral transport by moving chin up during a swallow. The hypothesis that CM applied by the patients after oral cancer excision during saliva swallowing will be helpful in swallowing of the barium suspension was not proved. In 10 of all the patients recurring aspiration was found despite CM application. Determination of aspiration risk is the key to efficient swallowing rehabilitation. The assessment of CM applied spontaneously by the patients' maintenance validity is particularly important. Video fluoroscopic examination of swallowing allows to assess the aforementioned issue and is crucial for better comprehension of CM applied by the patients in creating a new swallowing pattern after oral cancer excision.
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PMID:Compensatory Mechanisms in Patients After a Partial or Total Glossectomy due to Oral Cancer. 2648 64