scholarly journals Preoperative predictors of dysphagia after transoral surgery

2021 ◽  
Author(s):  
Kazunori Fujiwara ◽  
Kenkichiro Taira ◽  
Ryohei Donishi ◽  
Satoshi Koyama ◽  
Tsuyoshi Morisaki ◽  
...  
Keyword(s):  
Head And Neck ◽  
Forced Expiratory Volume ◽  
Transoral Surgery ◽  
Postoperative Dysphagia ◽  
Swallowing Function ◽  
History Of ◽  
Group A ◽  
Low Bmi ◽  
Head And Neck Radiotherapy

Abstract Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the preoperative predictive factors for postoperative dysphagia in patients undergoing TOS. Methods One hundred and twenty patients who underwent TOS were evaluated in this study. The degree of dysphagia was evaluated using the Functional Outcome Swallowing Scale (FOSS) both preoperatively and 3 months postoperatively. Those whose FOSS stage was maintained postoperatively were classified into the FOSS-M group, while those with increased FOSS stage postopratively were classified into the FOSS-I group. The following parameters were assessed before surgery: age, weight, height, body mass index (BMI), forced expiratory volume in 1 s, and history of head and neck radiotherapy. Videofluoroscopy (VF) was performed preoperatively to evaluate swallowing function using the Penetration-Aspiration Scale (PAS). Results The BMI of the FOSS-M group was significantly higher than that of the FOSS-I group. A history of radiotherapy was significantly more common in the FOSS-I group than in the FOSS-M group. Finally, preoperative PAS in the FOSS-M group was lower than that in the FOSS-I group. Conclusion This study suggested that patients with preoperative aspiration detected using VF might develop postoperative dysphagia severely. In addition, preoperative low BMI and a history of previous radiotherapy for head and neck cancer were associated with postoperative dysphagia. Objective examinations such as VF should be performed preoperatively.

scholarly journals Impact of early dysphagia intervention on swallowing function and quality of life in head and neck cancer patients treated with intensity-modulated radiation therapy or image guided radiation therapy with or without surgery/chemotherapy

2015 ◽  
Vol 01 (01) ◽  
pp. 037-043 ◽  
Author(s):  
Rajender Kumar ◽  
Hitesh Gupta ◽  
Keshavanand Konwar ◽  
Ritesh Sharma ◽  
Anil Anand ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Swallowing Function ◽  
Group A ◽  
Group B

Abstract Introduction: Dysphagia is a very common problem associated with head and neck cancer patients. Inspite of best of technologies like Intensity Modulated Radiotherapy (IMRT) or Image Guided Radiotherapy (IGRT), Dysphagia remains a major problem in locally advanced head and neck cancer patients. Materials and Methods: We randomized 50 head and neck cancer patients, including all sites and stages into two groups, 25 patients in each group. In Group-A dysphagia prevention exercises were done from the day of the onset of radiation therapy and continued till 6 months, while in Group-B no dysphagia interventions were given. We analyzed rate of dysphagia, aspiration rate and its impact on quality of life. We used M.D. Anderson Dysphagia Inventory (MDADI) which is a validated and reliable questionnaire designed specifically for evaluating impact of dysphagia on quality of life (QOL) in head and neck cancer patients. American Speech language Hearing Association (ASHA) scale was used for assessing swallowing function. Penetration Aspiration Scale (PAS) was used to assess aspiration during swallowing with the help of Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Results: Quality of life was significantly better in dysphagia preventive exercise arm (group - A). There was significant improvement in the MDADI score, from the baseline to 6 months in exercise arm (14 versus 7.76, p= 0.017). Swallowing function score was also in favour of exercise arm (6.44 versus 5.8, p=0.002). Patients in exercise arm were able to swallow much better by the end of 6 months post radiotherapy. Risk of silent aspiration as evaluated by PAS score at the end of three months was 36% (Group A = 16%, Group B = 20%). At the end of six months, it improved to 24% (Group A = 8%, Group B = 16%). There was a trend towards lesser incidence of aspiration in exercise arm, although it was not statistically significant (p=0.21). Conclusion: Results from this study demonstrated that swallowing exercises, if administered from first week of chemo-radiation and continued till 6 months, results in significant improvement in swallowing function and quality of life. Use of FEES helps in detection of silent aspiration at an early stage and reduces aspiration related morbidities.

scholarly journals Patient-reported quality-of-life outcomes in relation to provider-assessed adverse events during head and neck radiotherapy

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Joshua R. Niska ◽  
Cameron S. Thorpe ◽  
Michele Y. Halyard ◽  
Angelina D. Tan ◽  
Pamela J. Atherton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Head And Neck ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Patient Reported ◽  
Head And Neck Radiotherapy

Impact of Xerostomy on the Quality of Life of Patients after Head and Neck Radiotherapy

2018 ◽  
Vol 126 (3) ◽  
pp. e172
Author(s):  
Igor Henrique Morais Silva ◽  
Michele Lopes Do Nascimento ◽  
Raíssa Soares Dos Anjos ◽  
Raylane Farias De Albuquerque ◽  
Yuri Victor Siqueira Muniz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Head And Neck Radiotherapy

Comparison of patient-reported late treatment toxicity (LENT–SOMA) with quality of life (EORTC QLQ-C30 and QLQ-H&N35) assessment after head and neck radiotherapy

2010 ◽  
Vol 97 (2) ◽  
pp. 270-275 ◽  
Author(s):  
Kean Fatt Ho ◽  
Damien J.J. Farnell ◽  
Jacqueline A. Routledge ◽  
Meriel P. Burns ◽  
Andrew J. Sykes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Treatment Toxicity ◽  
Patient Reported ◽  
Eortc Qlq C30 ◽  
Late Treatment ◽  
Eortc Qlq ◽  
Head And Neck Radiotherapy

Quality of life assessment in patients above 60, below 50 years of age during and after curative radiotherapy in head and neck cancers

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5552-5552 ◽  
Author(s):  
A. Turaka ◽  
B. K. Mohanti ◽  
S. Chander ◽  
S. V. Deo ◽  
R. Jena ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Phase I ◽  
Head And Neck ◽  
Phase Ii ◽  
Younger Patients ◽  
Curative Radiotherapy ◽  
Group A ◽  
Group B

5552 Background: To evaluate the Quality of life in patients above 60 and below 50 years during and after curative radiotherapy in head and neck cancers. Methods: Head and Neck cancer patients who are to undergo curative radiotherapy (RT) were divided into two groups, 49 patients (Group A,above 60 years) and 40 patients (Group B,below 50). Quality of life assessment was done using EORTC QLQ C-30 version-2 at 4 phases;Pretreatment-Phase I,during RT-Phase II,1-month post RT-Phase III and 6 months post RT-Phase IV.Statistical analysis was done with mean scores using ’t’ test. Results: Physical functioning (PF)scores in both groups were highest in phase I (69.4;77.5, p < 0.035) and lowest in phase II (40; 50, p < 0.008) and the difference was statistically significant. Although PF scores declined in both groups in phase II, overall PF score remained higher in group B than in group A in all phases.Role functioning score remained low in both groups and the difference were not statistically significant at all phases. Emotional functioning score was highest in phase I (68.37; 69.15), but declined as treatment progressed, consequent to depression.The values improved over time, restored to near pretreatment values at phase IV. Cognitive functioning scores in both groups was also highest in phase I (70.07; 79.17). Social functioning of both groups declined during RT (42.52; 45)compared to pre RT values (73.47; 77.09). The mean Global Health Status score was higher in group B compared to group A at all phases, yet there was no statistical significance.The scores declined during RT (66.87 vs 35.62 & 64.79 vs 34.01), improved overtime but did not reach pre RT scores.The symptom scores were all higher for elderly patients compared with younger patients at all phases, implying elderly patients experienced more symptoms, with greater experience of symptoms during RT. Conclusions: Quality of Life of elderly patients was lower compared to younger patients at phase II in terms of physical functioning, social and emotional functioning. Global Health Status score was higher for younger patients than elderly at all phases, and declined in phase II. No significant financial relationships to disclose.

Effect of oral pilocarpine on xerostomia and quality of life in patients receiving curative radiotherapy for head and neck cancers

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6088-6088
Author(s):  
S. Goyal ◽  
D. N. Sharma ◽  
P. K. Julka ◽  
G. K. Rath
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Phase Ii ◽  
Head And Neck Cancers ◽  
Functional Scores ◽  
Symptom Scores ◽  
Oral Dryness ◽  
Group A ◽  
Group B

6088 Background: Xerostomia is the most debilitating condition following irradiation (RT) in patients with head and neck cancers. The present study intended to evaluate the effect of salivary stimulants such as pilocarpine given concurrent with RT on xerostomia and quality of life in these patients. Methods: In a prospective study conducted between July 2004 and May 2006, 60 patients receiving curative (radical or postoperative) RT for squamous cell head and neck carcinoma were randomized into two groups; group A (n=30) received concurrent pilocarpine 5 mg thrice daily for 12 weeks starting on day 1 of RT while group B (n=30) did not receive pilocarpine. Xerostomia was assessed using RTOG/EORTC criteria, and Quality of life (QOL) using EORTC QLQ-C30 version 3.0 and QLQ-H&N35 questionnaires in phases I-V: preradiation, week 4 of RT, and at 1, 3 and 6 months following completion of RT. Results: Oral dryness was the commonest toxicity, its incidence in phase II being 80% in group A and 89% in group B. By phase V, 13% patients in group A and none in group B had recovered to their pretreatment status. When compared with group B, group A had a significantly lower incidence of oral dryness in phases III (p=0.001), IV (p=0.014) and V (p=0.009) and lesser speech difficulty in phase V (p=0.021). QOL evaluation showed a decline in functional scores and rise in symptom scores during radiation with subsequent improvement to pretreatment levels in phase V. Group A had a significantly higher physical functioning score than group B in phases III (p=0.037) and IV (p=0.027), a better emotional functioning score in phases III (p=0.046) and IV (p=0.008), and a higher global health score, especially in phases II (p=0.012) and III (p=0.001). QLQ-C30 symptom scores were comparable between the 2 groups while H&N35 symptom scores were higher in group B with higher painkiller use in phase II (p=0.043) and IV (p=0.011), and higher dryness (p=0.025), sticky saliva (p=0.021) and constipation (p=0.011) in phase IV. Conclusions: Concurrent pilocarpine during head and neck RT helps maintain salivary function, reduces xerostomia and improves the quality of life in these patients, both during and after RT, especially in terms of parameters related directly to xerostomia. No significant financial relationships to disclose.

scholarly journals Dysphagia and Its Impact on Quality of Life of Head and Neck Cancer Patients: Institution Based Cross sectional Study

2020 ◽  
Author(s):  
Tseganesh Asefa Yifru ◽  
Sezer Kisa ◽  
Negalegn Getahun Dinegde ◽  
Niguse Tadele Atnafu
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Low Income ◽  
Swallowing Function ◽  
Advanced Tumor ◽  
Swallowing Problems

Abstract Objective: Assessing swallowing function using symptom-specific questionnaires on head and neck cancer (HNC) patients and supporting impaired swallowing to improve quality of life (QoL) of patients is recommended in different studies. However, there is no data that shows the effect of dysphagia on quality of life of Ethiopian patients. Hence, this study assessed the effect of dysphagia on quality of life domains of the MD Anderson Dysphagia inventory (MDADI) among head and neck cancer patients.Results: The study sample consisted of mostly male (53.90%), employed (70.6%), single (57.80 %) and completed some level of formal education (66.60 %) with mean age of 42.58 years (SD ± 14.08 years) and medical expense for about 69.6% of patients was covered by the government. Most of the patients were suffering from advanced stage HNC (59.80%) and squamous cell carcinoma (62.70%) and the most prevalent tumor location was nasal cavity/ nasopharyngeal carcinoma (40.20%). The mean MDADI composite score was 53.29 (SD± 15.85). Being female, low income, suffering from laryngeal/ hypo pharyngeal cancer, suffering from advanced tumor and those undergoing a single modality therapy were key determinants of poor QoL related to swallowing problems in HNC patients.

scholarly journals Effects of Prophylactic Swallowing Exercises on Dysphagia and Quality of Life in Patients with Head and Neck Cancer Receiving (Chemo) Radiotherapy. The Redyor Study: Protocol for a Randomized Clinical Trial.

2019 ◽  
Author(s):  
Anna Guillen-Sola ◽  
Neus Bofill-Soler ◽  
Ester Marco ◽  
Oscar Pera-Cegarra ◽  
Palmira Foro
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Head And Neck ◽  
Randomized Clinical Trial ◽  
Clinical Variable ◽  
Swallowing Function ◽  
Submental Muscles ◽  
Swallowing Dysfunction ◽  
Oropharyngeal Exercises

Abstract Background: Squamous carcinoma of the head and neck (HNC) has a high incidence in our context. Although therapeutic radiotherapy protocols try to preserve swallowing function and essential speech organs, dysphagia is a frequent symptom in the acute and long-term phases, due to the toxic effects of therapies needed to confront the illness. Some studies have shown prophylactic oropharyngeal exercises to be quite useful in improving swallowing function after completion of chemo-radiation therapy (CRT) protocols; others have focused on their use to prevent or minimize post-CRT swallowing dysfunction. Patients’ quality of life deteriorates greatly during CRT, with a peak of maximum intensity during the days immediately after finishing CRT treatment. Afterwards, function gradually improves, although scope or timeframe remains undetermined. Available evidence suggests that exercise therapy prior to oncological treatment could potentially improve deglutition and quality of life; however, a randomized study is needed to confirm this observation. Design/Methods: The Redyor singe-blind randomized clinical trial is designed to compare the effect of prophylactic oropharyngeal exercises on quality of life, dysphagia, and sustainability to the length of rehabilitative treatment. At enrollment, participants will be randomly assigned to one of two treatment groups. Both groups follow the protocol described here, although one group begins the training 2 weeks before initiating CRT and the other group just after finishing the therapy. Both groups will complete standard swallow therapy for training submental muscles involved and 3 sets of 5 inspiratory and expiratory repetitions using the Orygen Dual® valve, with a progressive weekly increase in workload. Discussion: This ongoing clinical trial, registered in 2016, is based on the hypothesis that undergoing a pre-radiotherapy rehabilitation (pre-habilitation) program will have greater benefits (less decrease in quality of life, less delay in swallowing parameters, and less severe dysphagia) compared to post-CRT rehabilitation. The primary objective is to assess dysphagia severity and evaluate quality of life due to swallowing dysfunction in HNC patients. Secondary objectives are to assess the correlation between a clinical variable and instrumental parameters in this period

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