A structured review and theme analysis of papers published on ‘quality of life’ in head and neck cancer: 2000–2005

A mastication test was needed with a material that forms a bolus and is soft enough to be chewed by persons with compromised oral function, in particular patients confronted with oral cancer. We therefore developed a wax-mixing ability test and compared it with a comminution test using Optocal as test food. We hypothesized that the mixing ability test would be better at differentiating between groups of persons with compromised masticatory performance than the comminution test. Sixty healthy subjects were recruited in three groups of 20, matched for age and gender: a group with natural dentition; a group with full dentures; and a group with maxillary denture and implant-supported mandibular overdenture. The mixing ability test was found to discriminate better between the two full-denture groups than the comminution test.

Mixing ability test compared with a comminution test in persons with normal and compromised masticatory performance.

This review examines the evidence regarding the clinical and neurophysiological differences between voluntary and spontaneous swallows. From the clinical point of view, voluntary swallow (VS) occurs when a human has a desire to eat or drink during the awake and aware state. Spontaneous swallow (SS) is the result of accumulated saliva and/or food remnants in the mouth. It occurs without awareness while awake and also during sleep. VS is a part of eating behavior, while SS is a type of protective reflex action. In VS, there is harmonized and orderly activation of perioral, lingual, and submental striated muscles in the oral phase. In SS, the oral phase is bypassed in most cases, although there may be partial excitation. Following the oral phase, both VS and SS have a pharyngeal phase, which is a reflex phenomenon that protects the upper airway from any escape of food and direct the swallowed material into the esophagus. This reflexive phase of swallowing should not be confused with SS. VS and SS are similar regarding their dependence on the swallowing Central Pattern Generator (CPG) at the brainstem, which receives sensory feedback from the oropharynx. There are differences in the role of the corticobulbar input between VS and SS.

Voluntary Versus Spontaneous Swallowing in Man

The movement-related cortical potential (MRCP) is a low-frequency negative shift in the electroencephalography (EEG) recording that takes place about 2 seconds prior to voluntary movement production. MRCP replicates the cortical processes employed in planning and preparation of movement. In this study, we recapitulate the features such as signal's acquisition, processing, and enhancement and different electrode montages used for EEG data recoding from different studies that used MRCPs to predict the upcoming real or imaginary movement. An authentic identification of human movement intention, accompanying the knowledge of the limb engaged in the performance and its direction of movement, has a potential implication in the control of external devices. This information could be helpful in development of a proficient patient-driven rehabilitation tool based on brain-computer interfaces (BCIs). Such a BCI paradigm with shorter response time appears more natural to the amputees and can also induce plasticity in brain. Along with different training schedules, this can lead to restoration of motor control in stroke patients.

/pdf/a-review-of-techniques-for-detection-of-movement-intention-a8hq96nhun.pdf

A Review of Techniques for Detection of Movement Intention Using Movement-Related Cortical Potentials

Assessment of mandibular invasion of squamous cell carcinoma by various modes of imaging: constructing a diagnostic algorithm.

Contingent negative variations associated with command swallowing in humans

Oral cancer is first treated with surgery for the patients. In most cases, it becomes difficult for these patients to perform smooth jaw movements postoperatively, causing masticatory dysfunctions, due to the mandible excision including muscles and peripheral nerves. However, it is still unknown whether the surgery affects the brain function for jaw movement in the patients. In this study, therefore, we investigated a significance of the movement-related cortical potential (MRCP) for jaw movements in the patients after the cancer surgery, to clarify the motor preparation process in the brain, as compared with healthy subjects. Eight normal subjects and seven patients with oral cancers were enrolled in the study. Experiment 1: The normal subjects were instructed to perform jaw-biting movement and hand movement, respectively. The MRCPs appeared bilaterally over the scalp approximately 1 to 2 s before the onset of muscle discharge in both movements. Experiment 2: The MRCPs appeared preoperatively in the jaw biting movement in all patients. However, the amplitudes of the MRCP decreased significantly after than before the surgery (p < 0.05). Our data indicated the dysfunction of the motor preparation process for jaw movements in the patient after the surgery, suggesting impairment of feed-forward system in the maxillofacial area.

/pdf/movement-related-cortical-potential-associated-with-jaw-45fpkc6g5d.pdf

Movement-Related Cortical Potential Associated with Jaw-Biting Movement in the Patients with Oral Cancer after the Surgery

This study evaluated the effect of oral cancer surgery on masticatory efficiency. Masticatory efficiency was measured using the ATP absorption method. Eating ability was measured using a questionnaire. Two groups were employed as controls: The "normal occlusion group" consisted of subjects who had a complete set of natural maxillary teeth opposed to mandibular teeth, and the "unilateral occlusion group" consisted of subjects who had lost their molar and premolar teeth on one side of the mandible as a result of caries or periodontal diseases. Three treatment groups, each of 6 patients, were studied: a glossectomy group, a marginal mandibulectomy group and a segmental mandibulectomy group. There were no differences in masticatory efficiency between two control groups. Masticatory efficiencies of the three oral cancer treatment groups were lower than in the unilateral occlusion group, even 12 months after surgery. Masticatory efficiency of the glossectomy group was significantly higher 12 months after surgery compared with pre-surgery. Masticatory and eating abilities of the marginal mandibulectomy group and the segmental mandibulectomy were reduced at 3 and 6 months after surgery. The masticatory efficiency 12 months after surgery was higher in the marginal mandibulectomy group than the segmental mandibulectomy group, although the difference was not statistically significant. The self assessed eating ability 12 months after surgery was significantly higher in the marginal mandibulectomy group than the segmental mandibulectomy group. These results suggest that discontinuation of the mandible may lead patients to eat only foods that do not require a substantial amount of chewing. Hence, the quality of life of patients in the marginal mandibulectomy group was considered to be better than that in the segmental mandibulectomy group.

/pdf/masticatory-efficiency-before-and-after-surgery-in-oral-17ey1s4mr2.pdf

Masticatory efficiency before and after surgery in oral cancer patients: comparative study of glossectomy, marginal mandibulectomy and segmental mandibulectomy.

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Contingent negative variations associated with command swallowing in humans

Movement-Related Cortical Potential Associated with Jaw-Biting Movement in the Patients with Oral Cancer after the Surgery

Masticatory efficiency before and after surgery in oral cancer patients: comparative study of glossectomy, marginal mandibulectomy and segmental mandibulectomy.