The effect of physical therapy on a case of oral cancer excision and flap reconstruction

When oral cancer patients have extensive surgery, there will be some obstacles in patients’ daily activities, such as facial deformity, eating and speech deficiency; especially difficulty in opening mouth that will influence chewing, speaking, facial expression and oral hygiene. These functional deficiencies can be improved by exercising, massaging, speech therapy and other rehabilitation.

A 56 years old male was diagnosed with oral squamous cell carcinoma and had an operation on 2010/04/08. The surgery included extensive excision of tumor, parts of lower jaw bones, and the lymph nodes and skin flap reconstruction. On 2010/05/03, the patient began radiotherapy and physical therapy on every Tuesday for about 45 minutes. Physical therapy includes skin flap pressing, soft tissues relaxation, shoulder/neck joint activity, and upper extremities muscle training. The patient education included facial expression, oral cavity exercise, neck exercise, and upper extremities muscle training. The frequency of home rehabilitation was three times a day with 10 to 15 minutes session.

The patient self-reported symptoms, including pain, drooling, mouth opening and vocalization difficulty and neck swelling), and the degree of closing mouth, head and shoulder mobility were assessed on the first, third and sixth months after surgery . The result shows that an improvement on mobilization of mouth, head, and shoulder receiving physical rehabilitation on the third and sixth month after surgery.