A Clinical Study Of Swallowing Function By Preservation Of Descending Branch Of Hypoglossal Nerve In Neck Dissection For Hypopharyngeal Carcinoma

ObjectiveTo observe the swallowing function after hypopharyngeal carcinoma resection by different surgical procedures of descending branch of hypoglossal nerve, and reseach the effort of preservation of descending branch of hypoglossal nerve to swallowing function after hypopharyngeal carcinoma resection.Materials and MethodsWe chose108hypopharyngeal carcinoma cases which were treated in the Qilu Hospital of Shandong University form July2012to Jan2014,101cases of males and7cases of females, aged40-79years old, with the average age59.2years old. In the cases,all the patients were performed tracheotomy and unilateral neck lymphnode dissection and hypopharyngeal carcinoma resection. According to the clinical stage of hypopharyngeal carcinoma, all the cases including5examples of stage1,19examples of stage II,35examples of stage III,49examples of stage IV.All the pathology was hypopharyngeal squamous-cell carcinoma.We excluded the cases with radical treatment, past neck surgery and severe systemic disseases.Based on different surgical methods of descending branch hypoglossal nerve, the patients were divided into two groups:group with preservation of descending branch hypoglossal nerve(group A,67cases) and group did not preserve the descending branch hypoglossal nerve (group B,41cases). In the group A, there were3examples of stage I,13examples of stage II,22examples of stage Ⅲ,29examples of stage Ⅳ; in the group B, there ware2examples of stage Ⅰ,6examples of stage Ⅱ,13examples of stage Ⅲ, 20examples of stage Ⅳ. We observed the swallowing function after hypopharyngeal carcinoma resection, evaluated by bedside water test, then statisticsed, analysised and contracted the two group by the SPSS18.0, in ordor to reseach the effort of preservation of descending branch hypoglossal nerve to swallowing function after hypopharyngeal carcinoma resection.ResultsIn group A(67cases),47cases successfully recovered swallowing function and20cases appeared dysphagia, the recovery rate was70.15%(47/67).In group B(41cases),16cases successfully recovered swallowing function and25cases appeared dysphagia, the recovery rate was39.02%(16/41).There was statistical significant between group A and group B(P=0.001<0.05). About the constituent ratio of clinical stage between group A and group B, there was no statistical significant (P=0.915>0.05)ConclusionsThere was statistical significant (P=0.001<0.05) between the group A and group B on the recovery rate of swallowing function. During neck lymphnode dissection for hypopharyngeal carcinoma,the preservation of descending branch hypoglossal nerve has positive effects to recover the swallowing function.So, to the patients whose cervical strap muscles (omohyoid, sternohyoid, sternothyroid and thyrohyoid)were not invaded by tumor, we’d better carefully preserve the descending branch hypoglossal nerve in neck dissection, in ordor to protect its innervation to cervical strap muscles, because it has positive effect to recover swallowing function after surgery, and improving the life qualityof the patients in the same time.