Impact of geniohyoid and masseter muscle masses on dysphagia after salvage surgery and radiotherapy in head and neck cancer

AbstractThis study aimed to determine whether geniohyoid and/or masseter muscle mass can predict the severity of dysphagia after salvage surgery for head and neck cancer. We conducted a retrospective cohort study of 45 male patients with head and neck cancer (median age, 68 years) who underwent salvage surgery. The preoperative geniohyoid and masseter muscle masses were evaluated using computed tomography and the severity of dysphagia was evaluated by Penetration Aspiration Scale (PAS), Functional Oral Intake Scale (FOIS) and Oropharyngeal swallow efficiency (OPSE). The median PAS, FOIS and OPSE scores after surgery were 7 (interquartile range [IQR] 1–8), 6 (IQR 2–7) and 95.8 (IQR 67.1–116.2), respectively. The mean geniohyoid muscle masses were 3.13 ± 0.78 cm2 and the mean masseter muscle masses were 4.37 ± 0.99 cm2, respectively. The multivariate analysis showed that the geniohyoid muscle mass was significantly associated with the PAS, FOIS and OPSE scores. Conversely, the masseter muscle mass was not significantly associated with the PAS score but was significantly associated with the FOIS and OPSE scores. Geniohyoid muscle mass may predict the severity of dysphagia after salvage surgery.

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Effect of Pretreatment Dysphagia on Postchemoradiation Swallowing Function in Head and Neck Cancer

Otolaryngology ◽

10.1177/01945998211009853 ◽

2021 ◽

pp. 019459982110098

Author(s):

Daniel J. Cates ◽

Lisa M. Evangelista ◽

Peter C. Belafsky

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Odds Ratio ◽

Independent Predictor ◽

Oral Intake ◽

Swallowing Function ◽

Swallowing Dysfunction ◽

The Mean ◽

Functional Oral Intake Scale

Objectives Chemoradiation therapy (CRT) for head and neck cancer can have profound effects on swallowing function. Identification of risk factors for development of swallowing dysfunction after CRT may improve allocation of preventive strategies. The purpose of this study is to determine the association between pre-CRT dysphagia and post-CRT swallowing dysfunction. Study Design Retrospective cohort study. Setting Academic medical center. Methods Patients with head and neck cancer were evaluated before and 3 months after CRT. Dysphagia was assessed with the Eating Assessment Tool (EAT-10). Swallowing dysfunction was evaluated by a videofluoroscopic swallow study and the Penetration-Aspiration Scale and swallowing safety was evaluated by the Functional Oral Intake Scale. The association between pre-CRT EAT-10 scores and post-CRT swallowing dysfunction was evaluated. Results The mean ± SD post-CRT Functional Oral Intake Scale score was 6.5 ± 1.2 for individuals with a pre-CRT EAT-10 score <3 and 5.3 ± 1.9 for those with a pre-CRT EAT-10 score ≥3 ( P < .001). The mean post-CRT Penetration-Aspiration Scale score was 2.2 ± 1.5 for individuals with a pre-CRT EAT-10 score <3 and 3.8 ± 2.6 for those with a pre-CRT EAT-10 score ≥3 ( P < .001). After multivariate analysis adjusting for age, tumor subsite, T classification, and primary surgery, pre-CRT dysphagia (EAT-10 ≥3) was an independent predictor of post-CRT aspiration (odds ratio, 4.19 [95% CI, 1.08-16.20]; P = .04) and feeding tube dependence (odds ratio, 3.54 [95% CI, 1.01-12.33]; P = .04). Conclusion The presence of dysphagia before chemoradiation for head and neck cancer is an independent predictor of swallowing dysfunction after completion of therapy. These results may help target intervention toward preventing swallowing dysfunction in high-risk individuals.

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Change in Nutritional Status and Dysphagia after Resection of Head and Neck Cancer

Nutrients ◽

10.3390/nu13072438 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2438

Author(s):

Ayumi Sadakane-Sakuramoto ◽

Yoko Hasegawa ◽

Kazuma Sugahara ◽

Nobuhide Horii ◽

Syota Saito ◽

...

Keyword(s):

Head And Neck Cancer ◽

High Risk ◽

Nutritional Status ◽

Head And Neck ◽

Surgical Resection ◽

Neck Cancer ◽

Oral Intake ◽

The Body ◽

Tongue Pressure ◽

Functional Oral Intake Scale

Nutritional status is well-known to influence patient recovery after resection of head and neck cancer (HNC). The influence of preoperative nutritional status on dysphagia was assessed in patients who underwent surgical resection of HNC along with the assessment of nutritional status during the acute and subacute phases. Eighty-six patients underwent surgical resection and dysphagia assessments (repetitive saliva-swallowing test, water-swallowing test, and functional oral intake scale) and had their tongue pressure assessed five times (before surgery, after 1–2 weeks, and 1, 2, and 3 months after surgery). The nutritional status was assessed according to the body mass index, total protein, and albumin. The prognostic nutritional index was calculated from preoperative data, and the subjects were classified into three groups: Low-risk, Attention and High-risk groups. After surgery, the nutritional status index values were low, and the High-risk group showed significantly lower values in comparison to the other two groups. The water-swallowing test and functional oral intake scale findings were worse than they had been preoperatively until 2 months after surgery, and a significant correlation was noted between the postoperative nutritional status and the presence of dysphagia. The results indicated that the preoperative nutritional status of HNC patients influenced their ability to ingest/swallow, which in turn influenced their nutritional status after HNC resection.

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Salvage Reconstructive Surgery During Nivolumab Therapy for a Patient With Hypopharyngeal Cancer

Clinical Medicine Insights Case Reports ◽

10.1177/1179547620908854 ◽

2020 ◽

Vol 13 ◽

pp. 117954762090885

Author(s):

Nayuta Tsushima ◽

Takeshi Shinozaki ◽

Takao Fujisawa ◽

Toshifumi Tomioka ◽

Wataru Okano ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Reconstructive Surgery ◽

Salvage Surgery ◽

Single Agent ◽

Oral Intake ◽

Hypopharyngeal Cancer ◽

Primary Disease ◽

Neck Disease

Objectives: Nivolumab, a fully IgG4-programmed death-1 inhibitor antibody, led to improved overall survival compared with single-agent therapy in patients with platinum-refractory recurrent head and neck cancers. In general, nivolumab is used in inoperable patients. To the best of our knowledge, there have been no reports of salvage surgery during nivolumab therapy for patients with head and neck cancer. We report the case of a woman treated with salvage reconstructive surgery during nivolumab therapy. Method: Case report and literature review. Results: The patient underwent nivolumab therapy for recurrent primary and neck disease after induction chemotherapy, followed by concurrent chemoradiation therapy. The neck disease shrunk, whereas the primary disease temporarily shrunk but later progressed again. Recurrent primary disease led to a narrowing of her airway, and she required airway management. We performed total pharyngolaryngectomy with free jejunal reconstruction, and her quality of life improved. The surgery was performed without complications and the postoperative course was uneventful. She was discharged postoperative day 18 with oral intake function and a safer airway. Conclusion: As far as we know, this is the first report of salvage surgery during nivolumab therapy for patients with head and neck cancer. The salvage reconstructive surgery in this case proceeded uneventfully.

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Salvage Surgery after Chemoradiotherapy for Head and Neck Cancer

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.61.111 ◽

2010 ◽

Vol 61 (2) ◽

pp. 111-111

Author(s):

R. Hayashi

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Salvage Surgery

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Longitudinal comparisons of a whole‐mouth taste test to clinician‐rated and patient‐reported outcomes of dysgeusia postradiotherapy in patients with head and neck cancer and associations with oral intake

Head & Neck ◽

10.1002/hed.26690 ◽

2021 ◽

Author(s):

Barbara Pisano Messing ◽

Elizabeth C. Ward ◽

Cathy Lazarus ◽

Keri Ryniak ◽

Jessica Maloney ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Patient Reported Outcomes ◽

Oral Intake ◽

Taste Test ◽

Patient Reported

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Relationship between oral intake, patient perceived swallowing impairment, and objective videofluoroscopic measures of swallowing in patients with head and neck cancer

Head & Neck ◽

10.1002/hed.25542 ◽

2018 ◽

Vol 41 (4) ◽

pp. 1016-1023 ◽

Cited By ~ 4

Author(s):

Loni C. Arrese ◽

Heidi J. Schieve ◽

Jennifer M. Graham ◽

Julie A. Stephens ◽

Ricardo L. Carrau ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Oral Intake

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Serum enzymes in head and neck cancer. II Aliesterase

The Journal of Laryngology & Otology ◽

10.1017/s0022215100102798 ◽

1987 ◽

Vol 101 (8) ◽

pp. 819-822 ◽

Cited By ~ 5

Author(s):

Harbans Lal ◽

H. C. Madan ◽

G. S. Kohli ◽

S. P. S. Yadav

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Mean Value ◽

Serum Enzymes ◽

The Mean

AbstractSerum aliesterase levels have been estimated in 38 patients with head and neck cancer. The mean value was significantly lower than in controls. The decrease in activity was greater in patients with ulcerative growths and it progressed with advancement in the stage of cancer.With radiotherapy, a progressive and significant increase in serum aliesterase activity was observed. In patients with non-malignant growths the activity was comparable with that in controls.

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