[原著］Induction Chemotherapyを行った口腔扁平上皮癌症例の術後言語機能に関する研究

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概要

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• Fifty one cases with squamous cell carcinoma in oral regions (25 tongue,15 floor of mouth, 11 lower gmgiva) were studied to reveal the effect of induction chemotherapy and movement of residual tongue for the postoperative speech function. Three surgicalsafe margins in the resection were decided in consideration of the grade of clinico-pathological malignancy and the clinical effect of induetion chemotherapy: the local resection for low grade of clinico-pathological malignancy with marked clinical effect of induction chemotherapy, the wide resection for high grade malignancy with none clinical effect in the chemotherapy and the partial resection for the others. Articulatory function after excision was assessed by 100 Japanese syllable speech intelligibility test. Tongue mobility of 42 cases was analysed with ultrasonography. The results of present study were as follows: 1) The post operative speech intelligibillity score was related to the extent of resected tongue and mouth floor, whereas correlation between the score and the extent of mandibulectomy was not observed. 2) The postoperative intelligibility score correlates with the grade of clonicopathological malignancy and the tumor size after induction chemotherapy. 3) The score of speech intelligibility was the best in the local resection cases, the secondly in the partial resection cases and the worst in the wide resection cases. 4) Tongue movement of the postoperative patient was smaller in amount, poorer in symmetricalness and slower in duration then normal. Especially the duration of tongue movement in the /ka/ sound was related to the speech intelligibility. These result suggested that the induction chemotherapy and surgical procedures taking into account the malignancy grade after the evaluation of the clinico-pathological findings will help to improve the postoperative speech function. Operation methods which conserve the mobility of residual tongue should be selected to minimize the postoperative speech disorders.

• 琉球医学会,Ryukyu Medical Associationの論文

著者

• 津波古 判

  沖縄赤十字病院歯科口腔外科

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