Clinical Research On Function Of Deglutition Of Patients With Maxillary Defects

PURPOSE:To review patients’ clinical information and follow-up with maxillary defects; to investigate function of deglutition in patients with maxillary defects; to research factors of function of deglutition in patients with maxillary defectsMETHODS: A retrospective collection of 328 patients undergoing maxillary surgery between June 2009 to April 2012 in Shanghai Ninth People’s Hospital. MDADI has been done in 328 patients with maxillary defects, and 8 of them took VFSS.RESULT:Among reasons leading to maxillary defects, malignant tumors accounted for 83.54%, benign tumors accounted for 10.96% and non-neoplastic lesions accounted for 5.49% only. Among them, the BrownⅡ、Ⅲ class and the Brown b class were the most, accounting for 85.06% and 86.15% respectively. Maxillary defects were mainly reconstructed by prosthesis or no-treatment(77.44%), soft tissue ranked the second(17.99%), and then the bone tissue(4.57%). MDADI scores of patients with Brown classⅠmaxillary defects were higher than any other classes, and statistical difference occurred(P<0.05). The difference between MDADI scores of patients with Brown classⅡ,Ⅲ,Ⅳmaxillary defects appeared to be little(P>0.05). In terms of maxillary reconstruction, for Brown classⅡmaxillary defect, function of deglutition was gradually improved in reconstruction of no treatment, prosthetic treatment, soft tissue reconstruction and bone reconstruction, and statistical difference occurred(P<0.0001). There was no statistical difference in functional subscale among four reconstructions(P>0.05), while there was statistical difference inemotional and physical subscale(P<0.05). In Brown classⅢmaxillary defect, function of deglutition was gradually improved in reconstruction of no treatment, prosthetic treatment and bone reconstruction, and statistical difference occurs(P<0.0001). There was statistical difference in functional, emotional and physical subscale(P<0.0001). Logistic regression revealed that type, pathology and reconstruction of maxillary defects had a significant effect on function of deglutition. VFSS showed function of deglutition was in order to rise in reconstruction of no treatment, prosthetic treatment, soft tissue reconstruction and bone reconstruction with patients suffering Brown classⅡb maxillary defect.CONCLUTION: Function of deglutition of patients with Brown classⅠmaxillary defects were better than other three classes and there was no significant difference among the other three maxillary defect classes. Function of deglutition gradually enhanced in groups of no treatment, prosthetic treatment, soft tissue reconstruction and bone reconstruction. Type, pathology and reconstruction of maxillary defects had a significant effect on function of deglutition.