Surgical variables affecting swallowing in patients treated for oral/oropharyngeal cancer

Background. Postoperative swallowing function may be influenced by a number of treatment variables; this study examines the relationship of various treatment factors to measures of swallow function. Methods. Swallowing was examined with the modified barium swallow procedure in 144 patients surgically treated for oral or oropharyngeal cancer 3 months after healing. Univariate and multivariate correlations were used to examine the relationship between swallowing function and treatment. Results. Percent tongue base resected and total volume resected were most often correlated with swallowing function in the univariate analyses. Multivariate analyses identified the following combinations with the strongest correlations: (1) percent tongue base resected and closure type for liquids; (2) percent tongue base resected and unreconstructed mandible for pastes; (3) total volume resected, percent lateral floor of mouth resected, and postoperative radiotherapy dose for masticated boluses. Conclusions. Total volume resected and percent tongue base resected had a profound impact on postoperative swallowing function. Combinations of percent tongue base resected with other surgical variables had the strongest relationships with overall swallowing function.