scholarly journals Therapeutic Singing as a Swallowing Intervention in Head and Neck Cancer Patients With Dysphagia

2021 ◽  
Vol 20 ◽  
pp. 153473542110650
Author(s):  
Seongmoon Jo ◽  
Myung Sun Yeo ◽  
Yoon-Kyum Shin ◽  
Ki Hun Shin ◽  
Se-Heon Kim ◽  
...  

Background: Head and neck cancer patients often suffer from dysphagia after surgery and radiotherapy. A singing-enhanced swallowing protocol was established to improve their swallowing function. This study aimed to evaluate the beneficial effects of therapeutic singing on dysphagia in head and neck cancer (HNC) patients. Methods: Patients who participated in this study were allocated to the intervention group (15 patients) and the control group (13 patients). Patients assigned to the intervention group received therapeutic singing 3 times per week for 4 weeks. Each group was divided into 2 subgroups, including the oral cavity cancer group and the pharyngeal cancer group. The patients’ vocal functions were evaluated in maximum phonation time, pitch, intensity, jitter, shimmer, harmonics to noise ratio, and laryngeal diadochokinesis (L-DDK). To evaluate swallowing function, videofluoroscopic swallowing study was done, and the results were analyzed by videofluoroscopic dysphagia scale (VDS) and dynamic imaging grade of swallowing toxicity (DIGEST). Results: Among the voice parameters, L-DDK of the intervention group significantly increased compared to that of the control group. Swallowing functions of the intervention group were significantly improved in VDS and DIGEST after the intervention. Detailed items of VDS and DIGEST showed improvements especially in the pharyngeal phase score of VDS, such as laryngeal elevation, pharyngeal transit time, and aspiration. In addition, the pharyngeal cancer group showed significant improvements in VDS and DIGEST scores after the intervention. Conclusions: Our outcomes highlight the beneficial effects of singing for HNC patients with dysphagia. The notable improvements in the pharyngeal phase suggest that therapeutic singing would be more appropriate for HNC patients who need to improve their intrinsic muscle movements of vocal fold and laryngeal elevation.

2020 ◽  
Author(s):  
Akira Ohkoshi ◽  
Kengo Kato ◽  
Takenori Ogawa ◽  
Ayako Nakanome ◽  
Ryo Ishii ◽  
...  

Abstract Background The latency of the swallowing reflex is an important factor causing dysphagia in head and neck cancer patients. Although there are many reports comparing swallowing function before and after treatment, few studies have focused on the latency of the swallowing reflex. The aim of this retrospective study was to clarify the changes in the latency of the swallowing reflex before and after treatment. Methods The latency of the swallowing reflex was quantified using the time from the injection of 1 ml of distilled water into the pharynx through a nasal catheter to the onset of swallowing. Results The latency time of the swallowing reflex was significantly decreased 3 months after treatment compared to before treatment. Significant reduction was also observed in patients with pharyngeal cancer who underwent chemoradiation therapy. Conclusions This retrospective study showed that a delayed swallowing reflex improved with treatment in advanced head and neck cancer patients.


2020 ◽  
Vol 10 (3) ◽  
pp. 317-328
Author(s):  
Dadi Hamdani ◽  
Awal Prasetyo ◽  
Anggorowati Anggorowati

Background: One of the chemotherapy side effects on head and neck cancer patients is anticipatory nausea. However, the anticipatory nausea problem has not been properly resolved. Nausea might be psychologically reduced by hypnotherapy. There only have been very few studies conducted to examine the effects of hypnotherapy in alleviating anticipatory nausea.Purpose: This study aimed to determine the effect of hypnotherapy using Hanung induction technique on anticipatory nausea in head and neck cancer patients undergoing chemotherapy.Methods: This research employed a pre-post test of quasi-experiment with control group design. Consecutive sampling technique was used to obtain 64 subjects who met inclusion and exclusion criteria and were equally divided into the intervention and control groups. Hypnotherapy as the intervention was carried out in two sessions, each of which lasted for 20 minutes, with a week distance between sessions. The data were collected using a visual analog scale (VAS), which was used twice to measure anticipatory nausea and analyzed using the paired and independent-sample t-test.Result: The results showed that the mean score of anticipatory nausea in the intervention group reduced from 7.6±1.4 to 2.3 ±1.2 after hypnotherapy, while the mean in the control group increased from 6.4±1.6 to 6.7±1.4. There was a significant difference in the score of anticipatory nausea after the implementation of hypnotherapy between the intervention and the control group (p<0.001).Conclusion: The study concluded that hypnotherapy is effective in reducing the intensity of anticipatory nausea in head and neck cancer patients undergoing chemotherapy. Therefore, hypnotherapy can be applied by oncology nurses as an intervention in treating anticipatory nausea.


2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 132-132
Author(s):  
Yasue Kimura ◽  
Masaru Morita ◽  
Hiroyuki Kawano ◽  
Hajime Ohtsu ◽  
Koji Ando ◽  
...  

132 Background: Esophageal cancer is highly aggressive and until recently is associated with a poor prognosis. Another clinical problem of esophageal cancer is the frequent association of head and neck cancer. The therapy for esophageal cancer and head and neck cancer is difficult. Definitive chemoradiotherapy is frequently indicated, while invasive surgical resections have been aggressively performed for patients with esophageal cancer associated with head and neck cancer. Methods: The Japanese 202 patients underwent esophagectomy were divided into two groups according to the association of head and neck cancer. The clinicopathological factors and the method of operations were evaluated and statistically analyzed. Results: The double cancer group included 26 (12.9%) patients that had the cancer of esophagus and the head and neck either synchronously or metachronously, while the control group included 176 (87.1%) patients with esophageal cancer. Seventeen patients were operated synchronously in double cancer group. No statistically significant differences were recognized in other clinical backgrounds such as the gender, location of the tumor, etc. Several types of operations were performed for two groups, such as subtotal esophagectomy, total laryngo-pharyngo-esophagectomy, cervical esophagectomy and laryngo-pharyngectomy and free jejunal transfer.salvage esophagectomy, and two-staged operation after definitive chemoradiotherapy. Salvage esophagectomy was performed in five patients with either remnant or recurrent esophageal cancer after definitive chemoradiotherapy. The mortality as well as morbidity rate of the double cancer group was not significantly different from the control group. Furthermore, patients’ prognosis was similar in the two groups. Conclusions: Esophagectomy can be an effective treatment option by adopting techniques that appropriate for each cases, such as staged operations after definitive chemoradiotherapy, muscular flaps and microvascular anastomosis, even in patients with double cancers of the esophagus and the head and neck cancer.


2017 ◽  
Vol 35 (3) ◽  
pp. 314-324 ◽  
Author(s):  
Femke Jansen ◽  
Anna M.H. Krebber ◽  
Veerle M.H. Coupé ◽  
Pim Cuijpers ◽  
Remco de Bree ◽  
...  

Purpose A stepped care (SC) program in which an effective yet least resource-intensive treatment is delivered to patients first and followed, when necessary, by more resource-intensive treatments was found to be effective in improving distress levels of patients with head and neck cancer or lung cancer. Information on the value of this program for its cost is now called for. Therefore, this study aimed to assess the cost-utility of the SC program compared with care-as-usual (CAU) in patients with head and neck cancer or lung cancer who have psychological distress. Patients and Methods In total, 156 patients were randomly assigned to SC or CAU. Intervention costs, direct medical costs, direct nonmedical costs, productivity losses, and health-related quality-of-life data during the intervention or control period and 12 months of follow-up were calculated by using Trimbos and Institute of Medical Technology Assessment Cost Questionnaire for Psychiatry, Productivity and Disease Questionnaire, and EuroQol-5 Dimension measures and data from the hospital information system. The SC program’s value for the cost was investigated by comparing mean cumulative costs and quality-adjusted life years (QALYs). Results After imputation of missing data, mean cumulative costs were ­€3,950 (95% CI, –€8,158 to –€190) lower, and mean number of QALYs was 0.116 (95% CI, 0.005 to 0.227) higher in the intervention group compared with the control group. The intervention group had a probability of 96% that cumulative QALYs were higher and cumulative costs were lower than in the control group. Four additional analyses were conducted to assess the robustness of this finding, and they found that the intervention group had a probability of 84% to 98% that cumulative QALYs were higher and a probability of 91% to 99% that costs were lower than in the control group. Conclusion SC is highly likely to be cost-effective; the number of QALYs was higher and cumulative costs were lower for SC compared with CAU.


ORL ◽  
2021 ◽  
pp. 1-3
Author(s):  
Jérôme R. Lechien ◽  
Daphné Delplace ◽  
Mohamad Khalife ◽  
Sven Saussez

Neutrophilic febrile dermatosis (NFD) is a rare paraneoplastic syndrome that may be found in patients with head and neck cancer. NFD may appear before the neoplasia and may only concern the dorsal faces of the hands. This article reports the NFD findings of a patient with pharyngeal cancer, which was developed 2 years after the occurrence of NFD. The development of NFD in patient with alcohol and tobacco consumption should lead otolaryngologists and dermatologists to suspect head and neck malignancy. In cases of normal otolaryngological examination, patients have to be followed.


2018 ◽  
Vol 16 (3) ◽  
Author(s):  
Reyna Aguilar Quispe ◽  
Adrielle Lindolpho Cremonesi ◽  
Jeanne Kelly Gonçalves ◽  
Cassia Maria Fischer Rubira ◽  
Paulo Sérgio da Silva Santos

ABSTRACT Objective To evaluate the oral health of patients with head and neck cancer after antineoplastic treatment, and to compare them with patients with no history of cancer. Methods A total of 75 patients, divided into Study Group, composed of individuals after antineoplastic treatment (n=30), and Control Group, with individuals with no history of cancer (n=45), aged 37 to 79 years. The oral health status was evaluated through the index of decayed, missing or filled permanent teeth (DMFT), community periodontal index and evaluation of the use and need of prosthesis. All of these items were evaluated according to the criteria recommended by the World Health Organization. The statistical analysis was descriptive and used the Pearson’s χ2 test. Results The community periodontal index was higher in the Study Group when compared to the Control Group (p<0.0001). The need for an upper (p<0.001) and lower (p<0.0001) prostheses was higher in the Study Group. Also, the use of upper prosthesis was higher in the Study Group (p<0.002). The missing or filled permanent teeth index between the two groups (p>0.0506) and the use of lower prosthesis (p>0.214) did not present a relevant statistical difference. Conclusion Periodontal disease and edentulism are the most significant changes in individuals who received antineoplastic therapy for head and neck cancer as well as greater need for oral rehabilitation.


2016 ◽  
Vol 14 (4) ◽  
Author(s):  
Sowmya V ◽  
Dipika Jayachander ◽  
Vijna Kamath ◽  
Mithun SK Rao ◽  
Mohammed Raees Tonse ◽  
...  

  Background: The study objective was to assess the development of xerophthalmia [dry eye syndrome (DES) or keratoconjunctivitis sicca] in head and neck cancer patients undergoing radiotherapy.Methods: Twenty two head and neck cancer patients requiring more than 60 Gy of curative radiotherapy/chemoradiotherapy and ten patients requiring radiotherapy/ chemoradiotherapy for treating cancers in the non head and neck regions (like breast, oesophagus, prostate, cervix and rectal cancers) were also enrolled in the study. The development of DES was studied at the beginning (day 0, before the start of radiotherapy) at day 21 (after completion of 30 Gy) and on completion of the treatment (> 60 Gy). As a comparative cohort, people with non head and neck cancer needing curative radiotherapy were also evaluated for comparison.Results: There was no difference in degree of DES between the Head and Neck cancer cohorts and non head and neck group at the beginning of treatment. However there was a statistically significant difference (p < 0.001) between the two groups at both mid and end of RT time point. Inter comparison between the various time points in the head and neck cancer group showed that the incidence of DES increased with the radiation exposure and was significant (pre to mid p < 0.001; and mid to end p < 0.005). A negative (r = -0.262) correlation was seen between DES and distance.Conclusions: The study showed that lesser the distance from the epicenter of the radiation to the orbital rim more was the severity of DES.


Author(s):  
Surender Kumar ◽  
Neha Salaria ◽  
Deepak Verma ◽  
Uma Garg ◽  
Monika Verma

Background- Head and neck squamous cell carcinomas(HNSCC) are one of the most widespread malignancies worldwide. Trace elements such as magnesium are essential at cellular level, and it has been suggested that magnesium plays a role in carcinogenesis. Methods- A hospital based case control study was conducted in a tertiary care medical college with an aim to determine the levels of serum magnesium in patients with head and neck cancer and to  compare  the  levels  of  serum  magnesium  of head and neck cancer patients   with healthy matched control  group  and  derive significance if any. Results- HNSCC was mainly found in males of age group 46 to 55 years. The mean serum Mg value of head and neck cancer patients was 0.71± 0.18 mmol/l while that seen in controls was 0.85± 0.09 mmol/l which was significantly lower(p<0.001). Average serum magnesium levels in stages I, II, III and IV were 0.85, 0.849, 0.682 and 0.554 mmol/l respectively, and a statistically significant association was determined between the two. Conclusion- As the stage of cancer progressed, average magnesium levels decreased congruently, hence establishing that magnesium levels were undeniably correlated to onset as well as progression of HNC. These evidences could be utilized to identify role of magnesium asa potential prognostic biomarker to assess progression of disease or clinical response to various modes of therapy in head and neck cancer patients.


Molecules ◽  
2019 ◽  
Vol 24 (19) ◽  
pp. 3560
Author(s):  
Li Tian ◽  
Lucas Wang ◽  
Yang Qiao ◽  
Linfeng Lu ◽  
Patrick Lee ◽  
...  

Irreversible electroporation (IRE) kills tumor cells by the delivery of short pulses of strong electric fields. However, the field strength decreases with distance from the treatment center. When IRE cannot eradicate the entire tumor mass, the surviving tumor cells can regrow. NVP-BEZ235 is a dual PI3K/mTOR inhibitor that has been administered orally in clinical trials. However, its hydrophobicity and poor water solubility make NVP-BEZ235 difficult to deliver to target areas. To improve its pharmacokinetics and therapeutic efficacy, we have encapsulated NVP-BEZ235 in a liposome (termed as L-BEZ). Our current study focuses on the long-term antitumor efficacy of IRE and intratumoral injection of L-BEZ in HN5 head and neck cancer xenografts in nude mice. We compared in vitro efficacy, as well as the effect on tumor size and growth rate in vivo, between IRE alone, IRE + oral BEZ, and IRE + L-BEZ over the course of two months. All animals in the control group were sacrificed by day 36, due to excess tumor burden. Tumors treated with IRE alone grew faster and larger than those in the control group. IRE + oral BEZ suppressed tumor growth, but the growth rate increased to that of the controls toward the end of 21 days. Only IRE + L-BEZ eradicated the tumor masses, with no palpable or extractable tumor mass observed after two months. The combination of IRE and L-BEZ could effectively eradicate tumors and prevent recurrence.


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