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Kaneoka A, Inokuchi H, Ueha R, Sato T, Goto T, Yamauchi A, Seto Y, Haga N. Longitudinal Analysis of Dysphagia and Factors Related to Postoperative Pneumonia in Patients Undergoing Esophagectomy for Esophageal Cancer. Dysphagia 2024; 39:376-386. [PMID: 37934250 PMCID: PMC11127821 DOI: 10.1007/s00455-023-10618-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/15/2023] [Indexed: 11/08/2023]
Abstract
Few studies have quantified longitudinal changes in swallowing in patients undergoing esophagectomy for esophageal cancer. This study longitudinally analyzed the changes in the Modified Barium Swallow Study Impairment Profile (MBSImP™) scores, swallowing kinematic measurements, and swallowing-related symptoms in patients undergoing esophagectomy. We also examined the association between identified swallowing impairment and aspiration pneumonia after surgery. We included consecutive patients who underwent esophagectomy and completed laryngoscopy and videofluoroscopy before, two weeks, and three months after surgery. We analyzed physiological impairments using the MBSImP. We also assessed the swallowing kinematics on a 5 mL thickened liquid bolus at three time points. Vocal fold mobility was assessed using a laryngoscope. Repeated measures were statistically examined for longitudinal changes in swallowing function. The association between the significant changes identified after esophagectomy and aspiration pneumonia was tested. Twenty-nine patients were included in this study. Preoperative swallowing function was intact in all participants. The timing of swallowing initiation and opening of the pharyngoesophageal segment remained unchanged after surgery. Tongue base retraction and pharyngeal constriction ratio worsened two weeks after surgery but returned to baseline levels three months after surgery. Three months after surgery, hyoid displacement and vocal fold immobility did not fully recover. Aspiration pneumonia occurred in nine patients after surgery and was associated with postoperative MBSImP pharyngeal residue scores. Decreased hyoid displacement and vocal fold immobility were observed postoperatively and persisted for a long time. The postoperative pharyngeal residue was associated with pneumonia and thus should be appropriately managed after surgery.
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Affiliation(s)
- Asako Kaneoka
- The University of Tokyo Hospital Rehabilitation Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan.
- The University of Tokyo Hospital Swallowing Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan.
| | - Haruhi Inokuchi
- The University of Tokyo Hospital Rehabilitation Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
- The University of Tokyo Hospital Swallowing Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Rumi Ueha
- The University of Tokyo Hospital Swallowing Center, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Taku Sato
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Takao Goto
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Akihito Yamauchi
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, The University of Tokyo, 7-3-1 Hongo Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Nobuhiko Haga
- Rehabilitation Services Bureau, The National Rehabilitation Center for Persons With Disabilities, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan
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Watanabe S, Gotoh M, Naitoh M, Ariji Y, Hirukawa A, Goto M, Ariji E, Nagao T. Alterations of posterior pharyngeal wall movement during swallowing in postoperative tongue cancer patients: assessment with a videofluoroscopic swallowing study. Odontology 2023; 111:228-236. [PMID: 35951139 DOI: 10.1007/s10266-022-00731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/29/2022] [Indexed: 01/12/2023]
Abstract
This study aimed to determine the association between the progressive contraction of the posterior pharyngeal wall and dysphagia in postoperative patients with tongue cancer. A videofluoroscopic swallowing study (VFSS) was performed in 34 patients after tongue cancer surgery. Images were analyzed using a two-dimensional video measurement software. Cases in which the processes on the posterior pharyngeal wall moved downward from the 2nd to 4th vertebral regions were defined as "normal type", other cases were defined as "abnormal type". Twenty-four patients showed normal movement of the posterior pharyngeal wall, whereas 10 patients showed the abnormal type. The results showed that there was a significant difference in dysphagia scores between the postoperative swallowing type and swallowing dysfunction score. This implies that dysphagia is related to the movement of the posterior pharyngeal wall after tongue cancer surgery. Furthermore, the extent of resection and stage were significantly different between the normal and abnormal groups in the posterior pharyngeal wall movement. There was also a significant difference between the two groups in terms of the following: whether the tongue base was included in the excision range (p < 0.01), whether neck dissection was performed (p < 0.01), or whether reconstruction was not performed (p < 0.01). VFSS results showed that posterior pharyngeal wall movement was altered after surgery in patients with tongue cancer who had severe dysphagia.
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Affiliation(s)
- Satoshi Watanabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan.
| | - Masakazu Gotoh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Munetaka Naitoh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Yoshiko Ariji
- Department of Oral Radiology, Osaka Dental University, Osaka, Japan
| | - Akiko Hirukawa
- Department of Oral Radiology, Osaka Dental University, Osaka, Japan
| | - Mitsuo Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Aichi, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Aichi, Japan
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Akamatsu M, Makino T, Morita S, Noda Y, Kariya S, Onoda T, Ando M, Kimata Y, Nishizaki K, Okano M, Oka A, Kanai K, Watanabe Y, Imanishi Y. Midline involvement and perineural invasion predict contralateral neck metastasis that affects overall and disease-free survival in locally advanced oral tongue squamous cell carcinoma. Front Oncol 2022; 12:1010252. [DOI: 10.3389/fonc.2022.1010252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAlthough patients with oral squamous cell carcinoma who develop contralateral neck metastasis (CLNM) have worse survival outcomes than those without CLNM, accurate prediction of occult CLNM in clinically negative contralateral neck (contralateral cN0) remains difficult. This study aimed to identify clinicopathological factors that could reliably predict CLNM in patients with locally advanced (clinical T3 and T4a) tongue squamous cell carcinoma (TSCC).Patients and methodsThe medical data of 32 patients with cT3–4a TSCC who underwent curative surgery between 2010 and 2017 were retrospectively analyzed. The correlation of clinicopathological variables with CLNM was examined using logistic regression analysis. The diagnostic performance of significant variables was evaluated using the area under the receiver operating characteristic curves (AUC). Overall survival (OS) and disease-free survival (DFS) were assessed using a Cox proportional hazards model.ResultsCLNM was eventually confirmed in 11 patients (34.4%). Multivariate logistic regression showed that midline involvement [odds ratio (OR) = 23.10, P = 0.017] and perineural invasion (PNI, OR = 14.96, P = 0.014) were independent predictors of CLNM. Notably, the prediction model comprising a combination of midline involvement and PNI exhibited superior diagnostic performance with an even higher OR of 80.00 (P < 0.001), accuracy of 90.3%, and AUC of 0.876. The multivariate Cox hazards model revealed independent significance of CLNM as an unfavorable prognostic factor for both OS [hazard ratio (HR) = 5.154, P = 0.031] and DFS (HR = 3.359, P = 0.038), as well as that of PNI for OS (HR = 5.623, P = 0.033).ConclusionOur findings suggest that coexisting midline involvement and PNI of the primary tumor is highly predictive of CLNM development, which independently affects both OS and DFS in patients with locally advanced TSCC. Such reliable prediction enables efficient control of CLNM by optimizing management of the contralateral cN0 neck, which will likely contribute to improved prognosis of those patients without unnecessarily compromising their quality of life.
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Werner HM, Miller CA, Tillman KK, Wang Y, Vorperian HK. Growth and sexual dimorphism of the hyoid bone and its relationship to the mandible from birth to 19 years: A three-dimensional computed tomography study. Anat Rec (Hoboken) 2021; 304:1901-1917. [PMID: 33580633 DOI: 10.1002/ar.24594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/07/2020] [Accepted: 12/23/2020] [Indexed: 11/07/2022]
Abstract
The hyoid bone and the hyomandibular complex subserve the functions of respiration, deglutition, and speech. This study quantified the growth of the hyoid bone and the hyomandibular relationships in males and females from birth to 19 years. Using 97 computed tomography (CT) scans, from a previous study (Kelly et al., 2017) on mandibular growth from 49 individuals (16 with longitudinal scans), landmarks were placed on 3D CT models and used to calculate four distance, and three angular measurements. A general increase in growth trend was observed in hyoid bone linear measurements-length, width, and depth-as well as relational mandible-to-hyoid distance, throughout the developmental ages examined in both males and females, with most variables having larger measurements for females up to age 10 years. A general decrease in all three angular measurements was observed in both males and females up to approximately age 12 years, at which time male angular measurements gradually increased with significant sexual dimorphism emerging after age 15 years. As expected, postpubertal males had greater hyoid angle than females; they also had greater hyoid angle of inclination than mandible body inclination (with inclination relative to the anterior-posterior nasal plane), likely related to hyo-laryngeal descent. This study contributes to normative data on hyoid bone and hyomandibular relational growth in typically developing individuals and provides a baseline against which structural and functional influences on anatomic growth may be examined by clinical disciplines that address the aerodigestive and speech functions, as well as the fields of anatomy, forensics, and anthropology.
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Affiliation(s)
- Helen M Werner
- Vocal Tract Development Lab, Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Biology, Beloit College, Beloit, Wisconsin, USA
| | - Courtney A Miller
- Vocal Tract Development Lab, Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Katelyn K Tillman
- Vocal Tract Development Lab, Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Yuan Wang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Houri K Vorperian
- Vocal Tract Development Lab, Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Pharyngeal Swallowing Pressures in Patients with Radiation-Associated Dysphagia. Dysphagia 2020; 36:242-249. [PMID: 32415490 DOI: 10.1007/s00455-020-10128-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
Dysphagia associated with radiotherapy for head and neck cancer is complex and can be difficult to treat. Videofluoroscopic swallow studies (VFSS) are the current gold-standard instrumented swallow assessment. High-resolution manometry (HRM) is an additional approach that provides objective measurements of swallowing-related pressures in the pharynx and esophagus. This can provide functional information on the pressure gradients underlying bolus propulsion, and is relevant for this patient population, where radiation-related fibrosis can lead to weakness and impaired pressure generation. The purpose of this preliminary study was to describe pharyngeal swallowing pressures in patients with radiation-associated dysphagia (RAD) and late radiation-associated dysphagia (LRAD) using HRM. RAD occurs during and immediately following treatment, whereas LRAD is a more recently described phenomenon in which the patient experiences an onset of dysphagia at least 5 years post-treatment. We performed a retrospective analysis of pharyngeal swallowing pressures from 21 patients with RAD or LRAD and 21 healthy sex/age-matched controls. Patients with RAD or LRAD exhibited decreased swallowing pressure durations throughout the pharynx (p ≤ 0.002), as well as decreased hypopharynx maximum pressure (p = 0.003) and pharyngeal contractile integral ( p < 0.0001). Understanding how pharyngeal pressure generation is altered in patients with a history of radiotherapy can help clinicians form more precise treatment plans.
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Utility and relevance of modified lateral trapezius myocutaneous flap as a locoregional reconstructive option for medium-sized ablative defects in head and neck cancer-our experience. Eur Arch Otorhinolaryngol 2020; 277:2539-2549. [PMID: 32270329 DOI: 10.1007/s00405-020-05952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Lateral trapezius myocutaneous (LTMC) flap has been used less frequently for defects pertaining to head and neck cancer ablative surgical defects. This study is to assess the utility of LTMC flap with a new modification of the flap design. METHODS This is a retrospective study using LTMC flap with modifications as a reconstructive option for intraoral & extraoral skin defects in head and neck cancer patients following ablative surgery, from August 2014 to October 2019 in a tertiary care hospital. The original technique of LTMC flap was modified for better results and outcomes. RESULTS Thirty-five patients underwent lateral trapezius flap reconstruction for ablative defects of oral cavity, laryngopharynx, neck and parotid. Twenty-three patients (65.71%) underwent adjuvant radiation/radiation-chemotherapy while one patient defaulted. Two patients (5.71%) had major flap failure. After the loss of flap in these patients, the operative technique was further modified for better results. However, the disadvantage of using this flap is shoulder disability. Nonetheless in the present study, the disability was reduced after modifying the operating technique by preserving the spinal accessory nerve. CONCLUSION The present study demonstrated minimal functional loss, low morbidity with satisfactory results, thus also reducing treatment cost. Thus, LTMC is a reliable reconstructive option in head and neck cancer patients for medium-sized defects.
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Ohashi N, Iwai T, Tohara H, Chiba Y, Oguri S, Koizumi T, Mitsudo K, Tohnai I. Swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy for organ preservation: a case-control study. Oral Radiol 2018; 35:230-238. [PMID: 30484199 DOI: 10.1007/s11282-018-0341-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to evaluate swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy (CRT). METHODS A videofluoroscopic swallowing study (VFSS) was used to evaluate swallowing function in 10 patients with advanced tongue cancer before and after bilateral neck dissection. RESULTS Laryngeal penetration increased in the postoperative VFSS. Temporal analysis comparing two time points revealed that, after surgery, oral transit time increased significantly, but there was no difference in pharyngeal delay time or pharyngeal transit time. Spatial analysis revealed significant decreases after surgery in the maximum distance of upper esophageal sphincter (UES) opening, the maximum distance of hyoid bone movement in both the anterior and superior direction, and the maximum velocity of hyoid bone movement. CONCLUSIONS Laryngeal penetration and aspiration increased as a result of limited hyoid movement and diminished UES opening after bilateral neck dissection following superselective intra-arterial CRT for advanced tongue cancer.
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Affiliation(s)
- Nobuhide Ohashi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Haruka Tohara
- Department of Gerontology and Gerodontology, Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yumi Chiba
- Cancer/Advanced Adult Nursing, Department of Nursing, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Toshiyuki Koizumi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Mat Lazim N, Abdullah K, Karakullukcu B, Tan IB. Feasibility of Salvage Selective Neck Dissection after Primary Irradiation of Pharyngeal and Laryngeal Carcinoma. ORL J Otorhinolaryngol Relat Spec 2018; 80:10-18. [PMID: 29428959 DOI: 10.1159/000486371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 12/17/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The concept of neck dissection (ND) in the management armamentarium of head and neck squamous cell carcinoma has evolved throughout the years. Nowadays, ND becomes more functional. METHODOLOGY A retrospective study of 865 patients was performed at Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital to investigate the feasibility of selective ND (SND). All patients with squamous cell carcinoma of the pharynx and larynx who received primary radiation and underwent salvage ND were included in the study. RESULT A total of 29 NDs were analyzed. In 17 neck sides, viable metastases were found (58%), whereas in the other 12 specimens there were no viable metastases. In 16 of the 17 necks (94%), the metastases were located either in level II, III, or IV or in a combination of these 3 levels. Level V was involved in only 1 case (6%). CONCLUSION It is well justified to perform a salvage SND (levels II, III, and IV) for pharyngeal and laryngeal carcinoma after primary radiation. In carefully selected cases of supraglottic and oropharyngeal carcinoma, a superselective ND also appears as an efficient option.
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Affiliation(s)
- Norhafiza Mat Lazim
- ORL-Head and Neck Surgery Department, School of Medical Sciences, Universiti Sains Malaysia, Health Campus Kota Bharu, Kota Bharu, Malaysia
| | - Kahairi Abdullah
- Department of Otolaryngology-Head and neck Surgery, Kulliyah of Medicine, International Islamic University Malaysia, Jalan Hospital, Kuantan, Malaysia
| | - Baris Karakullukcu
- Department of Head and Neck Surgical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Ing Bing Tan
- Department of Head and Neck Surgical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
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Analysis of swallowing after partial frontolateral laryngectomy with epiglottic reconstruction for glottic cancer. Eur Arch Otorhinolaryngol 2013; 271:2013-20. [PMID: 24100885 DOI: 10.1007/s00405-013-2750-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/28/2013] [Indexed: 10/26/2022]
Abstract
The aim of the study was to evaluate swallowing using a reproducible objective methodology and to seek preoperative factors that could influence swallowing outcomes in patients operated on for partial laryngectomy. Twenty-four patients who underwent partial frontolateral laryngectomy with epiglottic reconstruction for T1bN0 or T2N0 glottic carcinoma between 2008 and 2012 were retrospectively evaluated. Using fiberoptic endoscopic and videofluoroscopic evaluation, early (15 days postoperatively) and late (2 months postoperatively) scores were obtained for all patients to quantify their swallowing skills. Eighty-three percent of patients achieved at least partial oral feeding at time of hospital discharge and 87.5% achieved exclusive oral feeding within 2 months postoperatively. Early score was good or excellent in 50%, average in 4.2% and poor in 41.8%. Regarding late scores, 63% were classified as having a good or excellent late score, 7 patients (29%) were classified as "middle result" because their time to recover was longer (i.e. between 1 and 2 months postoperatively), and two patients had a poor late score. Finally, at last follow-up, only one patient was partially fed by gastrostomy (180 days after surgery). T stage (p = 0.04) was the only factor influencing early swallowing outcomes and length of hospital stay was longer for poor scores than for good late results (p = 0.02). Our findings show good outcomes in terms of postoperative swallowing. Objective assessment of deglutition is essential for a better understanding of the mechanisms of postoperative swallowing disorders and for patient selection.
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Guru K, Manoor UK, Supe SS. A comprehensive review of head and neck cancer rehabilitation: physical therapy perspectives. Indian J Palliat Care 2012; 18:87-97. [PMID: 23093823 PMCID: PMC3477371 DOI: 10.4103/0973-1075.100820] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rehabilitation in relation to cancer can be preventative, restorative, supportive, and palliative. It is recognized that patients may have rehabilitation needs throughout their care pathway. The role of physiotherapy in the cancer rehabilitation is less understood and particularly in the head and neck cancer (HNC) patients. This results in various residual deformities and dysfunctions for the patients with HNC. The objective of this review is to provide detailed information regarding the problems faced after the cancer treatments and rehabilitation of patients who suffered with HNC. The fact that cancer patients are facing several months of chemotherapy and/or radiotherapy and usually major surgery, as well as the direct effect of immobility due to pain, means that muscle wasting, joint stiffness, as well as de-conditioning and fatigue are inevitable. The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and quality of life. Following any treatment for HNC, physical therapy may play an essential role in preventing various complications and helping patients to mitigate impairments, and restoring function of the shoulder joint, neck, and face.
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Affiliation(s)
- Karthikeyan Guru
- Srinivas College of Physiotherapy and Research Center, Mangalore, India
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