A 49-year-old man after partial glossectomy shows which finding most likely on videofluoroscopic evaluation?

A 49-year-old man after partial glossectomy shows which finding most likely on videofluoroscopic evaluation?

• A. Difficulty Propelling Liquids Through the Oral Cavity
• B. Reduced Labial Seal
• C. Aspiration During the Swallow
• D. Difficulty Propelling Solids Through the Oral Cavity

Answer: (D)

The key idea is how the tongue drives the oral phase of swallowing. The tongue is the main propeller for moving the bolus from the front of the mouth toward the back. After a partial glossectomy, there’s reduced tongue bulk and mobility, which makes forming and pushing a cohesive bolus from solids much more difficult. Solids require grinding and careful shaping into a cohesive bolus and then anterior-to-posterior propulsion; with less tongue control, this propulsion through the oral cavity is impaired, and residue is more likely to remain. Liquids, while still relying on tongue motion, rely less on the extensive bolus shaping and can often be moved posteriorly with the remaining tongue and flow, so they’re less affected than solids in this scenario. Therefore, the most likely videofluoroscopic finding is difficulty propelling solids through the oral cavity. Reduced labial seal and aspiration during the swallow can occur in other contexts, but the tongue's impairment after partial glossectomy most directly disrupts solid propulsion in the oral stage.

The key idea is how the tongue drives the oral phase of swallowing. The tongue is the main propeller for moving the bolus from the front of the mouth toward the back. After a partial glossectomy, there’s reduced tongue bulk and mobility, which makes forming and pushing a cohesive bolus from solids much more difficult. Solids require grinding and careful shaping into a cohesive bolus and then anterior-to-posterior propulsion; with less tongue control, this propulsion through the oral cavity is impaired, and residue is more likely to remain. Liquids, while still relying on tongue motion, rely less on the extensive bolus shaping and can often be moved posteriorly with the remaining tongue and flow, so they’re less affected than solids in this scenario. Therefore, the most likely videofluoroscopic finding is difficulty propelling solids through the oral cavity. Reduced labial seal and aspiration during the swallow can occur in other contexts, but the tongue's impairment after partial glossectomy most directly disrupts solid propulsion in the oral stage.