FUNCTIONAL DISORDERS OF ORGANS OF THE ORAL CAVITY AND THEIR ELIMINATION WITH THE HELP OF PLASTIC IN PATIENTS WITH CANCER OF THE ORAL CAVITY AND OROPHARYNX

Tumors of the oral cavity and oropharynx occupy high positions in terms of prevalence.One of the methods of treatment is surgical, which leads to voluminous postoperativedefects. Therefore, the surgeon always faces the choice of reconstruction to restore orpreserve the functions of the oral cavity organs.The purpose of the study – to evaluate chewing and swallowing disorders and theeffectiveness of their elimination in various types of plastic surgery using chewingindicators and ultrasound examination of the swallowing act in patients with cancer ofthe oral cavity and oropharynx. Materials and methods. The study was conducted in 38 patients with cancer of the oral cavityand oropharynx, whom various types of plastics were applied to depending on the postoperativedefect to restore the function of the oral cavity organs. Determination of chewing indicatorsand ultrasound examination of the swallowing act were used before the surgical interventionand on the 10th day after it. The effectiveness of restoring the act of swallowing at differentvolumes of postoperative loss according to ultrasound data was calculated by the formula:Method effectiveness = ( .)( ) × 100%,where N is the number of factors (indicators), i = (1.6).Statistical analysis was carried out using Excel software from Microsoft Office 2003packages, STATISTICA 5.5The results. When using the chewing test, it was found that the loss of chewingefficiency in the postoperative period by 5-20 % is characteristic of all patients,compared to the indicators before the operation. During the ultrasound examinationof the act of swallowing in B- and M-mode in patients with cancer of the oral cavityand oropharynx, a decrease in the amplitude of contraction of the muscles of thesuprahyoid group in the longitudinal projection was found in patients with cancer ofthe oral cavity and oropharynx, which was less than 35 % in In B-mode and 40 % inM-mode. There was a decrease in the indicator in the lateral projection of the anteriorbelly of the digastric muscle on the side of tumor localization during swallowing in a rangeof 17-20 %. Therefore, these indicators indicate the restoration of the act of swallowing.Conclusions. To restore the function of the oral cavity organs in case of postoperativeloss of 1/3 of their volume, it is possible to close the defect with local tissues. For defectslarger than 1/3 of the volume, it is necessary to plastic by regional or free flaps on thevascular pedicle, and for larger defects involving bones, the use of bone autograft incombination with a free arterialized graft is recommended.