1
|
Nayiga BK, Abrams SW, Rhayel A, Edward H, Tang A, Kho ME, Sebestien H, Smith-Turchyn J. Exploring the use of rehabilitation in individuals with head and neck cancer undergoing treatment: a scoping review. Disabil Rehabil 2024:1-21. [PMID: 38494954 DOI: 10.1080/09638288.2024.2328810] [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: 04/21/2023] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
Explore the use, characteristics, feasibility, and functional outcomes of rehabilitation interventions used for individuals with head and neck cancer (HNC) during treatment. Searches were conducted in four databases from Jan 2011 to Dec 31, 2022. Included studies had to include adults with HNC undergoing treatment, a rehabilitation intervention, an assessment of functional outcome(s) addressed by the International Classification of Functioning Framework (ICF) and be published in English language. Title and abstract screening, full-text review, and data extraction were completed independently, in duplicate. Descriptive statistics and a qualitative synthesis summarized findings. Twenty-seven studies were included in this review. The majority of studies were randomized controlled trials (70%). Most individuals represented in the included studies were males (92% of all participants) between 50 and 60 years of age. Interventions led by a speech language pathologist (33%) were most commonly described. Sixteen studies (59%) described primary outcomes that fit the ICF "impairment" domain. We identified few studies that explored the use, feasibility, and effectiveness of rehabilitation interventions for individuals with HNC during treatment. Future research should assess the effectiveness of rehabilitation interventions on functional outcomes beyond the ICF body function and structure domain.
Collapse
Affiliation(s)
- Brenda Kibuka Nayiga
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Sophia Werden Abrams
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ashwak Rhayel
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Holly Edward
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Michelle E Kho
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Hotte Sebestien
- Department of Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
2
|
Meng NH, Li CI, Hua CH, Lin TC, Chiu CJ, Lin CL, Tsai MH, Chiu PJ, Chang WD, Tsou YA. Longitudinal changes in swallowing function after surgery and proactive swallowing therapy for oral cancer. Head Neck 2023. [PMID: 37155345 DOI: 10.1002/hed.27373] [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: 08/07/2022] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND This study aimed to describe and explore the longitudinal changes in swallowing function among patients with oral cancer who underwent surgery and proactive swallowing therapy from baseline to 1-year postoperation. METHODS We retrospectively studied 118 patients over a 4.5-year duration. Swallowing functional assessment including 10-item Eating Assessment Tool (EAT-10), Functional Oral Intake Scale (FOIS), M. D. Anderson Dysphagia Inventory, and Modified Barium Swallow Impairment Profile (MBSImP™) was performed at baseline, 1-month, 6-month, and 1-year postoperatively. RESULTS All swallowing parameters worsened 1-month postoperation. EAT-10, FOIS, and MBSImP™ oral and pharyngeal impairment scores improved significantly compared with 1-month postoperation at 6 months. Other swallowing parameters, except for weight, did not differ significantly from baseline at 6 months. The rate of tube-feeding dependency was 11.5% and 5.6% at 1 and 6 months postoperation, respectively. CONCLUSIONS Periodic swallowing functional assessments help delineate the longitudinal changes in swallowing functional outcomes.
Collapse
Affiliation(s)
- Nai-Hsin Meng
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
| | - Chia-Ing Li
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hung Hua
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Jen Chiu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Lin Lin
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Hsui Tsai
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Pei-Ju Chiu
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
| | - Wen-Dien Chang
- Department of Sport Performance, National Taiwan University of Sport, Taichung, Taiwan
| | - Yung-An Tsou
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
- Department of Otolaryngology - Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
3
|
Sagalow ES, Kumar AT, Banoub RG, Xiao K, Zhan T, Luginbuhl A, Curry JM. Recurrence of premalignant oral cavity and oropharynx lesions after pulsed diode laser treatment. Am J Otolaryngol 2022; 43:103556. [DOI: 10.1016/j.amjoto.2022.103556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/17/2022] [Accepted: 07/31/2022] [Indexed: 11/01/2022]
|
4
|
Heo J, Lim JH, Lee HR, Jang JY, Shin YS, Kim D, Lim JY, Park YM, Koh YW, Ahn SH, Chung EJ, Lee DY, Seok J, Kim CH. Deep learning model for tongue cancer diagnosis using endoscopic images. Sci Rep 2022; 12:6281. [PMID: 35428854 PMCID: PMC9012779 DOI: 10.1038/s41598-022-10287-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/29/2022] [Indexed: 12/29/2022] Open
Abstract
In this study, we developed a deep learning model to identify patients with tongue cancer based on a validated dataset comprising oral endoscopic images. We retrospectively constructed a dataset of 12,400 verified endoscopic images from five university hospitals in South Korea, collected between 2010 and 2020 with the participation of otolaryngologists. To calculate the probability of malignancy using various convolutional neural network (CNN) architectures, several deep learning models were developed. Of the 12,400 total images, 5576 images related to the tongue were extracted. The CNN models showed a mean area under the receiver operating characteristic curve (AUROC) of 0.845 and a mean area under the precision-recall curve (AUPRC) of 0.892. The results indicate that the best model was DenseNet169 (AUROC 0.895 and AUPRC 0.918). The deep learning model, general physicians, and oncology specialists had sensitivities of 81.1%, 77.3%, and 91.7%; specificities of 86.8%, 75.0%, and 90.9%; and accuracies of 84.7%, 75.9%, and 91.2%, respectively. Meanwhile, fair agreement between the oncologist and the developed model was shown for cancer diagnosis (kappa value = 0.685). The deep learning model developed based on the verified endoscopic image dataset showed acceptable performance in tongue cancer diagnosis.
Collapse
Affiliation(s)
- Jaesung Heo
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - June Hyuck Lim
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hye Ran Lee
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Jeon Yeob Jang
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Yoo Seob Shin
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea
| | - Dahee Kim
- Department of Otorhinolaryngology, Yonsei University, Seoul, Republic of Korea
| | - Jae Yol Lim
- Department of Otorhinolaryngology, Yonsei University, Seoul, Republic of Korea
| | - Young Min Park
- Department of Otorhinolaryngology, Yonsei University, Seoul, Republic of Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University, Seoul, Republic of Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun-Jae Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jungirl Seok
- Department of Otorhinolaryngology-Head & Neck Surgery, National Cancer Center, Goyang, Republic of Korea
| | - Chul-Ho Kim
- Department of Otolaryngology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
| |
Collapse
|
5
|
Constantinescu G, Rieger J, Seikaly H, Eurich D. Adherence to Home-Based Swallowing Therapy Using a Mobile System in Head and Neck Cancer Survivors. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2465-2475. [PMID: 34463544 DOI: 10.1044/2021_ajslp-21-00026] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose A large knowledge gap related to dysphagia treatment adherence was identified by a recent systematic review: Few existing studies report on adherence, and current adherence tracking relies heavily on patient self-report. This study aimed to report weekly adherence and dysphagia-specific quality of life following home-based swallowing therapy in head and neck cancer (HNC). Method This was a quasi-experimental pretest-posttest design. Patients who were at least 3 months post-HNC treatment were enrolled in swallowing therapy using a mobile health (mHealth) swallowing system equipped with surface electromyography (sEMG) biofeedback. Participants completed a home dysphagia exercise program across 6 weeks, with a target of 72 swallows per day split between three different exercise types. Adherence was calculated as percent trials completed of trials prescribed. The M. D. Anderson Dysphagia Inventory (MDADI) was administered before and after therapy. Results Twenty participants (75% male), with an average age of 61.9 years (SD = 8.5), completed the study. The majority had surgery ± adjuvant (chemo)radiation therapy for oral (10%), oropharyngeal (80%), or other (10%) cancers. Using an intention-to-treat analysis, adherence to the exercise regimen remained high from 84% in Week 1 to 72% in Week 6. Radiation therapy, time since cancer treatment, medical difficulties, and technical difficulties were all found to be predictive of poorer adherence at Week 6. A statistically significant improvement was found for composite, emotional, and physical MDADI subscales. Conclusions When using an mHealth system with sEMG biofeedback, adherence rates to home-based swallowing exercise remained at or above 72% over a 6-week treatment period. Dysphagia-specific quality of life improved following this 6-week treatment program.
Collapse
Affiliation(s)
- Gabriela Constantinescu
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Jana Rieger
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Hadi Seikaly
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
- Division of Otolaryngology-Head and Neck Surgery, University of Alberta Hospital, Edmonton, Canada
| | - Dean Eurich
- School of Public Health, Li Ka Shing Center for Health Research Innovation, Edmonton, Alberta, Canada
| |
Collapse
|
6
|
Foley J, Ward EC, Burns CL, Nund RL, Wishart L, Graham N, Patterson C, Ashley A, Fink J, Tiavaasue E, Comben W. Speech pathology service enhancement for people with head and neck cancer living in rural areas: Using a concept mapping approach to inform service change. Head Neck 2021; 43:3504-3521. [PMID: 34477267 DOI: 10.1002/hed.26850] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Speech pathology (SP) services provide swallowing and communication intervention to people with head and neck cancer (HNC) across the continuum of care. However, difficulties exist with access and delivery of services in rural areas. The study aim was to identify actionable goals for SP change, utilizing a concept mapping approach. METHODS Eleven SP staff from two regional/remote services completed the concept mapping process. Multivariate analysis and multidimensional scaling were used to develop a final set of prioritized goals for change. RESULTS Between the two participating health services, 30 actionable goals were identified within the "green-zone" on the go-zone graph of importance and changeability. Among the most highly rated areas for change was the need to deliver and receive more support for training, mentoring, and supervision to consolidate skills. CONCLUSIONS This methodology enabled identification of prioritized, actionable changes to improve SP services for people with HNC living in regional/remote areas.
Collapse
Affiliation(s)
- Jasmine Foley
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia
| | - Elizabeth C Ward
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.,Speech Pathology Department, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Clare L Burns
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.,Speech Pathology Department, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Rebecca L Nund
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia
| | - Laurelie Wishart
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.,Centre of Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia.,Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| | - Nicky Graham
- Speech Pathology Department, Children's Health Queensland Hospital and Health Service, Wondai Hospital, Wondai, Queensland, Australia
| | - Corey Patterson
- Speech Pathology Department, The Townsville University Hospital, The Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Amy Ashley
- Speech Pathology Department, The Townsville University Hospital, The Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Julie Fink
- Speech Pathology Department, The Townsville University Hospital, The Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Emily Tiavaasue
- Speech Pathology Department, The Mount Isa Hospital, North West Hospital and Health Service, Mount Isa, Queensland, Australia
| | - Wendy Comben
- Speech Pathology Department, The Townsville University Hospital, The Townsville Hospital and Health Service, Townsville, Queensland, Australia
| |
Collapse
|
7
|
Melgaço SDA, Vicente LCC, Gama ACC. Analysis of decannulation time and oral intake recovery in oral cancer patients. Codas 2021; 33:e20190236. [PMID: 34346947 DOI: 10.1590/2317-1782/20202019236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 10/12/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE to analyze the time of decannulation and oral diet release of patients undergoing oral cancer surgery at the Hospital Alberto Cavalcante and to verify which factors are associated with the time of decannulation and oral diet release. METHODS an observational study of the database of 33 adult patients surgically treated with oral cancer and served between 2012 and 2017. The socio-demographic variables (age and gender) and clinical variables (type of surgery, surgical extension, type of reconstruction, clinical conditions and times of decannulation and reintroduction of the oral route) were collected through electronic medical records analysis. Descriptive statistical analysis was performed with measures of central tendency, dispersion and proportions. For the association analysis, the non-parametric Mann-Whitney U test was used for independent samples. RESULTS of the 33 participants, male and elderly predominated, 69.8% underwent resection of more than one structure. The median time of decannulation among patients with oral cancer was 8 days, and oral clearance of 9.5 days. Resections with more than one structure, the presence of fistula and dehiscence interfered in the oral release time. CONCLUSION the median time of decannulation was eight days and oral release time of 9.5 days. Resections with more than one structure, the presence of fistula, and suture dehiscence are associated with increased oral release time.
Collapse
Affiliation(s)
- Silmara de Abreu Melgaço
- Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | - Laelia Cristina Caseiro Vicente
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | - Ana Cristina Côrtes Gama
- Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| |
Collapse
|
8
|
Bachmann AS, Höche S, Peters B, Wiltfang J, Hertrampf K. Effects of high-frequency speech therapy on speech-related quality of life and objective speech intelligibility of oral cancer patients. J Craniomaxillofac Surg 2021; 49:1072-1080. [PMID: 34193379 DOI: 10.1016/j.jcms.2021.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/11/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022] Open
Abstract
To analyze objective and subjective progression of speech intelligibility in oral cancer patients undergoing high-frequency speech therapy during early rehabilitation. Oral cancer patients in the Department of Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany, participated in the study from March 2016 to November 2017. Speech intelligibility was analyzed preoperatively (t1), post radiation (t2), and post speech therapy (t3). Objective measures were the Munich Intelligibility Profile (Online) and the Frenchay Dysarthria Assessment-2 (FDA-2). Subjective measures were the Speech Handicap Index (SHI), the speech subscale of the EORTC QLQ-C30&HN35, and the WHO-5 Index II. For nine patients with complete data, progression analyses showed a non-existent-to-low intelligibility impairment at t1 (means/SDs: e.g. FDA-2: 8.96/0.11, SHI: 17.5/15.15), increasing towards t2 (means/SDs/p-values for difference from t1: e.g. FDA-2: 7.40/0.80/0.000, SHI: 21.7/14.24/0.213), and then decreasing towards t3, without ever reaching the initial level (means/SDs/p-values for difference from t1: e.g. FDA-2: 8.22/0.60/0.005, SHI: 23.5/15.85/0.481). The objective changes in intelligibility were significant; the subjective changes were not. Overall, the ability to speak intelligibly after oral cancer treatment follows a typical pattern. Therefore, high-frequency speech therapy in the early rehabilitation phase might be recommendable. It might help patients to adapt to their situation after surgery, and facilitates compensating for possible functional deficits.
Collapse
Affiliation(s)
- Anne Susann Bachmann
- Institute of Psychology, Christian-Albrechts-University Kiel, Olshausenstr. 62, 24118, Kiel, Germany
| | - Svea Höche
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Building B, D-24105, Kiel, Germany
| | - Benno Peters
- Institute for Scandinavian Studies, Frisian Studies and General Linguistic Christian-Albrechts-University Kiel, Leibnizstr. 10, 24118, Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Building B, D-24105, Kiel, Germany
| | - Katrin Hertrampf
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Building B, D-24105, Kiel, Germany.
| |
Collapse
|
9
|
Eadie TL, Durr H, Sauder C, Nagle K, Kapsner-Smith M, Spencer KA. Effect of Noise on Speech Intelligibility and Perceived Listening Effort in Head and Neck Cancer. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1329-1342. [PMID: 33630664 PMCID: PMC8702834 DOI: 10.1044/2020_ajslp-20-00149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/13/2020] [Accepted: 09/22/2020] [Indexed: 05/19/2023]
Abstract
Purpose This study (a) examined the effect of different levels of background noise on speech intelligibility and perceived listening effort in speakers with impaired and intact speech following treatment for head and neck cancer (HNC) and (b) determined the relative contribution of speech intelligibility, speaker group, and background noise to a measure of perceived listening effort. Method Ten speakers diagnosed with nasal, oral, or oropharyngeal HNC provided audio recordings of six sentences from the Sentence Intelligibility Test. All speakers were 100% intelligible in quiet: Five speakers with HNC exhibited mild speech imprecisions (speech impairment group), and five speakers with HNC demonstrated intact speech (HNC control group). Speech recordings were presented to 30 inexperienced listeners, who transcribed the sentences and rated perceived listening effort in quiet and two levels (+7 and +5 dB SNR) of background noise. Results Significant Group × Noise interactions were found for speech intelligibility and perceived listening effort. While no differences in speech intelligibility were found between the speaker groups in quiet, the results showed that, as the signal-to-noise ratio decreased, speakers with intact speech (HNC control) performed significantly better (greater intelligibility, less perceived listening effort) than those with speech imprecisions in the two noise conditions. Perceived listening effort was also shown to be associated with decreased speech intelligibility, imprecise speech, and increased background noise. Conclusions Speakers with HNC who are 100% intelligible in quiet but who exhibit some degree of imprecise speech are particularly vulnerable to the effects of increased background noise in comparison to those with intact speech. Results have implications for speech evaluations, counseling, and rehabilitation.
Collapse
Affiliation(s)
- Tanya L. Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Holly Durr
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Cara Sauder
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kathleen Nagle
- Department of Speech-Language Pathology, Seton Hall University, South Orange, NJ
| | - Mara Kapsner-Smith
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kristie A. Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| |
Collapse
|
10
|
The nurse-patient interaction during rehabilitation consultations in patients surgically treated for head and neck cancer- a qualitative study. Eur J Oncol Nurs 2021; 53:101985. [PMID: 34275744 DOI: 10.1016/j.ejon.2021.101985] [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: 04/30/2020] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE Patients treated surgically for head and neck cancer may experience detrimental early and late effects of their treatment and are in need of rehabilitation post treatment to alleviate symptoms and effects. This study aimed to explore nurse-patient interactions during rehabilitation consultations assessing needs of patients in order to understand how nurses and patients experienced the consultation, the extent to which patients experienced being involved in the needs assessment and how patients experienced the information delivered. METHODS Findings in this study drew on three data sources: 15 observations of nurse-patient interactions during rehabilitation consultations; 15 individual patient interviews and a focus group interview with nurses. Observations and individual patient interviews took place at three different time points during the patient trajectory. The method and analysis applied Interpretive Description and Systematic Text Condensation. Analysis was performed across all three data sources and three time points. RESULTS Four interrelated themes were identified, showing that conducting rehabilitation nursing consultations and actively involving patients is a complex process. The themes revealed the complexity: expectations for nurse-patient interaction differ; challenges of building rapport; barriers to adequately identifying rehabilitation needs; and factors inhibiting communication of advice and recommendations. Uncovering emotional needs were especially challenging. Patient further experienced an information overload, especially just prior to discharge. CONCLUSION Nurse-patient interaction in the rehabilitation consultation is complex and involves many different interrelated aspects that require the nurse to have the necessary interpersonal and professional skills to support the patient to enhance their involvement in the encounter.
Collapse
|
11
|
Baijens LWJ, Walshe M, Aaltonen LM, Arens C, Cordier R, Cras P, Crevier-Buchman L, Curtis C, Golusinski W, Govender R, Eriksen JG, Hansen K, Heathcote K, Hess MM, Hosal S, Klussmann JP, Leemans CR, MacCarthy D, Manduchi B, Marie JP, Nouraei R, Parkes C, Pflug C, Pilz W, Regan J, Rommel N, Schindler A, Schols AMWJ, Speyer R, Succo G, Wessel I, Willemsen ACH, Yilmaz T, Clavé P. European white paper: oropharyngeal dysphagia in head and neck cancer. Eur Arch Otorhinolaryngol 2021; 278:577-616. [PMID: 33341909 PMCID: PMC7826315 DOI: 10.1007/s00405-020-06507-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. METHODS Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. RESULTS Twenty-four sections on HNC-specific OD topics. CONCLUSION This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.
Collapse
Affiliation(s)
- Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Otto-von-Guericke University, Magdeburg, Germany
| | - Reinie Cordier
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Patrick Cras
- Department of Neurology, Born Bunge Institute, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Lise Crevier-Buchman
- Voice, Speech, Swallowing Lab, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UVSQ and Research lab CNRS-UMR7018, Hôpital Foch, Suresnes, France
| | - Chris Curtis
- Swallows Head and Neck Cancer Charity, Blackpool, UK
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, Poznan University of Medical Sciences, Poznan, Poland
| | - Roganie Govender
- Head and Neck Cancer Centre, University College London Hospital, London, UK
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Kevin Hansen
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kate Heathcote
- Robert White Centre for Airway, Voice and Swallow, Poole Hospital NHS Foundation Trust, Dorset, UK
| | - Markus M Hess
- Deutsche Stimmklinik, Hamburg, Germany
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sefik Hosal
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Atılım University, Medicana International Ankara, Ankara, Turkey
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - C René Leemans
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, The Netherlands
| | - Denise MacCarthy
- Division of Restorative Dentistry and Periodontology, Faculty of Health Sciences, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Beatrice Manduchi
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Jean-Paul Marie
- Department of Otorhinolaryngology, Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Reza Nouraei
- Department of Ear Nose and Throat Surgery, The Robert White Centre for Airway Voice and Swallowing, Poole Hospital NHS Foundation Trust, University of Southampton, Southampton, UK
| | - Claire Parkes
- Department of Speech and Language Therapy, St. James's Hospital, Dublin, Ireland
| | - Christina Pflug
- Departement of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Walmari Pilz
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Nathalie Rommel
- Department Neurosciences, Experimental Otorhinolaryngology, Deglutology, University of Leuven, Leuven, Belgium
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Renee Speyer
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Health, School of Health and Social Development, Victoria, Australia
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
- Department of Oncology, University of Turin, Orbassano, TO, Italy
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anna C H Willemsen
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Taner Yilmaz
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| |
Collapse
|
12
|
Chiang TY, Huang CH, Kuan CH, Horng SY, Hsieh JH, Wu YF, Chuang SY, Yu YH, Ho CC, Cheng NC, Tai HC. Resuming Oral Feeding in Patients With Oral Squamous Cell Carcinoma With Free Anterolateral Thigh Flap Reconstruction. Ann Plast Surg 2021; 86:S108-S112. [PMID: 33438960 DOI: 10.1097/sap.0000000000002652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Quality of life and functional improvement have emerged as important goals for patients with oncologic disease. For patients with head and neck cancer, free anterolateral thigh (ALT) flaps serve as reliable reconstruction and provide functional restoration. Nevertheless, factors affecting the resumption of oral feeding are rarely described. This study aimed to evaluate and compare the functional outcomes of oral feeding for patients with different oncologic defect patterns and reconstructive ALT flap designs. METHODS We retrospectively reviewed patients with head and neck cancer undergoing oncologic ablation and free ALT reconstruction between January 2016 and April 2018 at National Taiwan University Hospital. Patients were categorized into 2 groups as through-and-through (T&T) and non-through-and-through (non-T&T) according to the defect pattern. We further subgrouped T&T patients into lip resection/lip sparing according to lip involvement. Reconstructive ALT flaps were of 2 designs, folded (F-ALT) and chimeric (C-ALT). Outcomes of oral feeding were analyzed using descriptive statistics, and differences between groups were compared using the Student t test. RESULTS We identified 233 patients who received oncologic ablation and free ALT flap reconstruction. There was no significant difference in functional recovery between the T&T and non-T&T groups (81.2% vs 73%, P = 0.137). However, among patients who succeeded in resuming oral feeding, lip-sparing patients had better functional recovery in terms of early oral feeding within 6 months and nasogastric tube removal compared with lip-resection patients (100% vs 83.3%, P = 0.001). Moreover, the F-ALT design resulted in a higher success rate in resuming oral feeding compared with the C-ALT design (90.5% vs 54.6%, P = 0.032). CONCLUSIONS Patients with head and neck cancer with T&T defects were associated with higher rates of secondary flap revision and a trend of delayed oral feeding. In the long term, improved oral feeding outcome with the F-ALT design was observed compared with the C-ALT design in the specific group with T&T defect.
Collapse
Affiliation(s)
- Ting-Yen Chiang
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Chieh-Huei Huang
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Chen-Hsiang Kuan
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Shyue-Yih Horng
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Jung-Hsien Hsieh
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Yu-Feng Wu
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Shu-Yang Chuang
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Ya-Han Yu
- National Taiwan University and College of Medicine, Taipei
| | | | - Nai-Chen Cheng
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| | - Hao-Chih Tai
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital
| |
Collapse
|
13
|
Wu JJ, Gao X, Wang WJ, Aly G, Chen J, Hu YQ, Jian XC, Jiang CH. [Influence of mandibulotomy approaches on oral function following radical resection of tongue carcinoma]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:280-283. [PMID: 32573135 DOI: 10.7518/hxkq.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to compare the influences of postoperative oral function in patients with median or paramedian mandibulotomy during the radical resection of tongue carcinoma and to provide evidence for the choice of osteotomy location for mandibulotomy. METHODS The clinical data of 126 patients who underwent combined radical neck dissection with mandibulectomy and glossectomy followed by simultaneous reconstruction were analyzed retrospectively. The patients were divided into two groups according to the position of mandibulotomy: median mandibulotomy group (median group, n=60) and paramedian mandibulotomy group (paramedian group, n=66). The fourth edition of the University of Washington Quality of Life Questionnaire (UW-QOL) was used to compare the differences in oral functions, such as swallowing, mastication, and speech, between the two groups during regular follow-up. SPSS 24.0 software package was used for statistical analysis, and P<0.05 was considered statistically significant. RESULTS Six months after the operation, no significant differences in swallowing, mastication, and speech functions were found between the median and paramedian groups. However, the swallowing and speech functions in the paramedian group were better than those in the median group 1 year after the operation (P<0.05), whereas no statistical difference in mastication function was observed between the two groups. CONCLUSIONS Evaluation of the postoperative oral function results showed that paramedian mandibulotomy was a better surgical approach than median mandibulotomy. Paramedian mandibulotomy is worth prioritizing in the radical resection of tongue carcinoma.
Collapse
Affiliation(s)
- Jian-Jun Wu
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xing Gao
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Wen-Jin Wang
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Gomaa Aly
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jie Chen
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Ya-Qin Hu
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xin-Chun Jian
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Can-Hua Jiang
- Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| |
Collapse
|
14
|
Shinn E, Jensen K, McLaughlin J, Garden A, Fellman B, Liang L, Peterson S. Interactive website for head and neck cancer patients: Adherence and coping program to prevent dysphagia after radiation. Internet Interv 2019; 18:100289. [PMID: 31890636 PMCID: PMC6926207 DOI: 10.1016/j.invent.2019.100289] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/19/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Pharyngeal and laryngeal cancers are highly curable; however survivors are at high risk for long-term dysphagia after radiation. To address lack of access to preventive care in community settings, we developed a responsive web-based application to help patients adhere to preventive swallowing exercises and cope with radiation side effects. We conducted an interim study analysis to determine website usage characteristics and to examine the effect size for future trials. METHODS Pharyngeal and laryngeal cancer patients were recruited for enrollment by speech language pathologists before primary radiation and introduced to the interactive website. The program (English and Spanish) features tracking logs for preventive exercises, instructional videos, patient stories and search features. Patients' self-reported swallowing function was assessed with the MD Anderson Dysphagia Inventory (MDADI) at baseline and at 6 months. Adherence to preventive exercises was assessed during the 10 week intervention. Number of unique website visits, total duration of website exposure, and rankings of the most popular webpages were calculated. Preliminary regression models were run using adherence and MDADI as outcomes. RESULTS Of the 160 enrolled, 96 had 10-week adherence data and 61 had 6-month MDADI data. The average age was 63 (SD = 12.26), 49.4% were from rural counties, 44% had a high school education or lower, and 42% reported annual income of $30,000 or less. The average number of visits was 5.49 (SD = 9.96) and the average total time spent with the website was 41.09 min (SD =88.48). Preliminary analyses indicated that number of unique visits to the website was independently associated with increased adherence to preventive exercises (p = .001-.008). CONCLUSION Our website showed significant effects in promoting adherence to swallowing exercises. However, our return visit rate showed that the platform needs improvement in navigability and usability for this older population undergoing challenging treatment in community settings with low resources.
Collapse
Affiliation(s)
- E.H. Shinn
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, United States of America
| | - K. Jensen
- Texas Health Care- Head and Neck Cancer Center of Texas, THC-PLLC, United States of America
| | | | - A.S. Garden
- Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, United States of America
| | - B.M. Fellman
- Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, United States of America
| | - Li Liang
- Department of Biostatistics, University of Texas M. D. Anderson Cancer Center, United States of America
| | - S.K. Peterson
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, United States of America
| |
Collapse
|
15
|
Aggarwal P, Zaveri JS, Goepfert RP, Shi Q, Du XL, Swartz M, Lai SY, Fuller CD, Lewin JS, Piller LB, Hutcheson KA. Swallowing-related outcomes associated with late lower cranial neuropathy in long-term oropharyngeal cancer survivors: cross-sectional survey analysis. Head Neck 2019; 41:3880-3894. [PMID: 31441572 DOI: 10.1002/hed.25923] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 07/06/2019] [Accepted: 08/07/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to quantify the association of late lower cranial neuropathy (late LCNP) with swallowing-related quality of life (QOL) and functional status among long-term oropharyngeal cancer (OPC) survivors. METHODS Eight hundred eighty-nine OPC survivors (median survival time: 7 years) who received primary treatment at a single institution between January 2000 and December 2013 completed a cross-sectional survey (56% response rate) that included the MD Anderson Dysphagia Inventory (MDADI) and self-report of functional status. Late LCNP events ≥3 months after cancer therapy were abstracted from medical records. Multivariate models regressed MDADI scores on late LCNP status adjusting for clinical covariates. RESULTS Overall, 4.0% (n = 36) of respondents developed late LCNP with median time to onset of 5.25 years post-treatment. LCNP cases reported significantly worse mean composite MDADI (LCNP: 68.0 vs no LCNP: 80.2; P < .001). Late LCNP independently associated with worse mean composite MDADI (β = -6.7, P = .02; 95% confidence interval [CI], -12.0 to -1.3) as well as all MDADI domains after multivariate adjustment. LCNP cases were more likely to have a feeding tube at time of survey (odds ratio [OR] = 20.5; 95% CI, 8.6-48.9), history of aspiration pneumonia (OR = 23.5; 95% CI, 9.6-57.6), and tracheostomy (OR = 26.9; 95% CI, 6.0-121.7). CONCLUSIONS In this large survey study, OPC survivors with late LCNP reported significantly poorer swallowing-related QOL and had significantly higher likelihood of poor functional status. Further efforts are necessary to optimize swallowing outcomes to improve QOL in this subgroup of survivors.
Collapse
Affiliation(s)
- Puja Aggarwal
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.,University of Texas School of Public Health, Houston, Texas
| | - Jhankruti S Zaveri
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Qiuling Shi
- Department of Symptom Research, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Xianglin L Du
- University of Texas School of Public Health, Houston, Texas
| | - Michael Swartz
- University of Texas School of Public Health, Houston, Texas
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.,Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - C David Fuller
- Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Jan S Lewin
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Linda B Piller
- University of Texas School of Public Health, Houston, Texas
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.,Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| |
Collapse
|
16
|
Parke SC, Oza S, Shahpar S, Ngo-Huang A, Herbert A, Barksdale T, Gerber L. Identifying Gaps in Research on Rehabilitation for Patients With Head and Neck Cancer: A Scoping Review. Arch Phys Med Rehabil 2019; 100:2381-2388. [PMID: 31082380 DOI: 10.1016/j.apmr.2019.03.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/30/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Examine the amount and nature of research activity in head and neck cancer (HNC) rehabilitation; highlight publication trends, including information about the authors, settings, and study designs; and identify gaps in the existing literature. DATA SOURCES Eligible studies were identified using PubMed, Embase, and CINAHL databases. STUDY SELECTION Inclusion criteria included human subjects, English language, publication between 1/1/1990 and 4/30/2017, HNC patients at any timepoint in disease, and evaluation of rehabilitation outcomes as described by the International Classification of Functioning, Disability and Health (ICF) framework. Exclusion criteria included intervention or outcome not specific to rehabilitation or the HNC population, and protocols or abstracts without corresponding full manuscripts. DATA EXTRACTION An established 6-step scoping review framework was utilized to develop the review protocol. A 3-level review was then performed. Data on eligible studies were collected using a Research Electronic Data Capture (REDCap) tool. DATA SYNTHESIS Among 2201 publications, 258 met inclusion criteria. Publication rate increased by 390% over the study timeframe. Most studies were observational (n=150). Few were interventional (n=35). The most common interventions focused on chewing or swallowing (n=14), followed by exercise (n=10). Most primary outcome measures fit the ICF definition of impairment; fewer fit the definitions of activity limitation or participation restriction. CONCLUSIONS Although research volume in HNC rehabilitation is increasing, the literature is dominated by small (≤100 patients), outpatient-based observational studies involving chewing or swallowing-related impairments. More prospective studies in multidisciplinary domains across the cancer care continuum are needed. There is particular need for interventional studies and prospective observational studies. Future studies should evaluate clinically-relevant activity limitations and participation restrictions. Rehabilitation professionals have an important role in the design of future HNC rehabilitation research.
Collapse
Affiliation(s)
- Sara C Parke
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Sonal Oza
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sam Shahpar
- Department of Physical Medicine and Rehabilitation, Shirley Ryan AbilityLab, Northwestern University, Chicago, IL
| | - An Ngo-Huang
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Aliea Herbert
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Touré Barksdale
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lynn Gerber
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| |
Collapse
|
17
|
What Are We Really Measuring? A Content Comparison of Swallowing Outcome Measures for Head and Neck Cancer Based on the International Classification of Functioning, Disability and Health (ICF). Dysphagia 2019; 34:575-591. [PMID: 30945002 DOI: 10.1007/s00455-019-10005-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 03/23/2019] [Indexed: 10/27/2022]
Abstract
A combination of outcome measures are required to provide important information on the physiological profile and associated impact of dysphagia in head and neck cancer (HNC). Choosing the most appropriate tool can be a difficult and time-consuming process. The aim of this study was to identify and then compare the content of tools commonly used to assess swallowing post HNC care using the International Classification of Functioning Disability and Health (ICF) as a reference. A literature audit of 11 databases was conducted for relevant articles published between January 2004 and June 2017 and total of 502 papers met the inclusionary criteria. These papers were audited and 27 tools were identified which met the study criteria. The meaningful concepts contained in each tool were mapped to the ICF. Within the 27 tools, 898 meaningful concepts were identified and matched to 60 ICF categories. The most frequently matched ICF categories related to body functions, while comparatively few concepts matched to activity and participation and environmental factors. This study has identified that a large number of tools are currently being used in HNC research to measure swallowing outcomes. The sheer number of tools available to explore dysphagia post HNC highlights the lack of a uniform approach to outcome measurement which limits the potential to compare and combine research studies in order to strengthen treatment evidence. There is a need to develop an international consensus for a core outcome set of swallowing related measures, that capture the holistic impact of dysphagia, for HNC.
Collapse
|
18
|
Figueiredo IC, Vendramini SHF, Lourenção LG, Sasaki NSGMDS, Maniglia JV, Padovani Junior JA, Raposo LS, Santos MDLSG. Profile and speech-language rehabilitation of patients with laryngeal cancer. Codas 2019; 31:e20180060. [PMID: 30843924 DOI: 10.1590/2317-1782/20182018060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022] Open
Abstract
PURPOSE to describe the clinical and sociodemographic profile and analyze the voice rehabilitation outcomes of patients with laryngeal cancer. METHODS cross-sectional study with 204 individuals with laryngeal cancer treated between 1989 and 2015. The variables describing the patients' profile were presented in absolute values (n) and percentage (%). The association between the speech-language therapy outcome and the sociodemographic and clinical characterization variables was verified by means of uni- and multivariate techniques. RESULTS 95.1% of the patients are male; 53.43% are aged 60 or more; 77.37% have elementary education; 44.12% are in the service industry; 81.63% smoke and consume alcohol; 30.4% are stage T3. Absence of nodules was found in 72.00%, and of metastasis, in 85.6% of patients. The most frequent therapeutic procedure was complete or partial laryngectomy (69.61%). There was an association among education, disease stage, habits, and therapeutic outcome with speech-language therapy (p<0.001). CONCLUSION Several causes can affect the prognosis of vocal rehabilitation in patients with laryngeal cancer. Optimization and diversification of new therapeutic procedures are challenges for these patients' speech-language rehabilitation.
Collapse
Affiliation(s)
| | | | | | | | - José Vitor Maniglia
- Faculdade de Medicina de São José do Rio Preto - FAMERP - São José do Rio Preto (SP), Brasil
| | | | - Luiz Sergio Raposo
- Faculdade de Medicina de São José do Rio Preto - FAMERP - São José do Rio Preto (SP), Brasil
| | | |
Collapse
|
19
|
Arrese LC, Hutcheson KA. Framework for Speech-Language Pathology Services in Patients with Oral Cavity and Oropharyngeal Cancers. Oral Maxillofac Surg Clin North Am 2019; 30:397-410. [PMID: 30266189 DOI: 10.1016/j.coms.2018.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This article provides a framework speech-language pathology services to optimize functional outcomes of patients with oral cavity and oropharyngeal cancers. Key principles include (1) a proactive rehabilitation model that minimizes intervals of disuse or inactivity of speech and swallowing systems, (2) standardized evaluation paradigms that combine objective instrumental assessments with patient-reported outcome measures, and (3) systematic methods for surveillance and intensive rehabilitation for late dysphagia.
Collapse
Affiliation(s)
- Loni C Arrese
- Department of Otolaryngology - Head and Neck Surgery, Ohio State University, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| |
Collapse
|
20
|
|
21
|
Messing BP, Ward EC, Lazarus C, Ryniak K, Kim M, Silinonte J, Gold D, Thompson CB, Pitman KT, Blanco R, Sobel R, Harrer K, Ulmer K, Neuner G, Patel K, Tang M, Lee G. Establishing a Multidisciplinary Head and Neck Clinical Pathway: An Implementation Evaluation and Audit of Dysphagia-Related Services and Outcomes. Dysphagia 2018; 34:89-104. [PMID: 29922848 PMCID: PMC6349813 DOI: 10.1007/s00455-018-9917-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/02/2018] [Indexed: 11/28/2022]
Abstract
Head and neck cancer (HNC) guidelines recommend regular multidisciplinary team (MDT) monitoring and early intervention to optimize dysphagia outcomes; however, many factors affect the ability to achieve these goals. The aims of this study were to explore the barriers/facilitators to establishing and sustaining a MDT HNC care pathway and to examine the dysphagia-related speech-language pathology (SLP) and dietetic components of the pathway. Using the Consolidated Framework for Implementation Research (CFIR), a mixed methods study design was used to evaluate an established MDT HNC pathway. Ten MDT members provided perceptions of facilitators/barriers to implementing and sustaining the pathway. Patients attending the SLP and dietetic components of the pathway who commenced treatment between 2013 and 2014 (n = 63) were audited for attendance, outcome data collected per visit, and swallowing outcomes to 24-month post-treatment. Dysphagia outcomes were compared to a published cohort who had received intensive prophylactic dysphagia management. Multiple CFIR constructs were identified as critical to implementing and sustaining the pathway. Complexity was a barrier. Patient attendance was excellent during treatment, with low rates of non-compliance (< 15%) to 24 months. Collection of clinician/patient outcome tools was good during treatment, but lower post-treatment. Dysphagia outcomes were good and comparable to prior published data. The pathway provided patients with access to regular supportive care and provided staff opportunities to provide early and ongoing dysphagia monitoring and management. However, implementing and sustaining a HNC pathway is complex, requiring significant staff resources, financial investment, and perseverance. Regular audits are necessary to monitor the quality of the pathway.
Collapse
Affiliation(s)
- Barbara Pisano Messing
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA. .,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia. .,Greater Baltimore Medical Center, The Milton J. Dance, Jr. Head & Neck Center, 6569 N. Charles Street, PPW Suite 401, Baltimore, MD, 21204, USA.
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.,Centre for Functioning and Health Research, Metro South Hospital and Health Service, Queensland Government, Brisbane, QLD, Australia
| | - Cathy Lazarus
- Department of Otolaryngology-Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, Thyroid Head and Neck Research Center, Thyroid Head and Neck Cancer (THANC) Foundation, Mount Sinai Beth Israel, New York, NY, USA
| | - Keri Ryniak
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Melissa Kim
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Jessica Silinonte
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Dorothy Gold
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Carol B Thompson
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen T Pitman
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Ray Blanco
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Ryan Sobel
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Karen Harrer
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Karen Ulmer
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Geoffrey Neuner
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Kruti Patel
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Mei Tang
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| | - Gregory Lee
- Greater Baltimore Medical Center, The Milton J Dance, Jr. Head and Neck Center, Johns Hopkins Head & Neck Surgery, Johns Hopkins Voice Center, Baltimore, MD, USA
| |
Collapse
|
22
|
Varadarajan VV, Arshad H, Dziegielewski PT. Head and neck free flap reconstruction: What is the appropriate post-operative level of care? Oral Oncol 2017; 75:61-66. [DOI: 10.1016/j.oraloncology.2017.10.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/22/2017] [Accepted: 10/23/2017] [Indexed: 11/25/2022]
|
23
|
Constantinescu G, Rieger J, Mummery K, Hodgetts W. Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:1296-1303. [PMID: 29098271 DOI: 10.1044/2017_ajslp-17-0040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/10/2017] [Indexed: 05/23/2023]
Abstract
PURPOSE Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), other advantages are not as well understood. One example is the potential for mHealth devices and apps to enhance adherence to treatment regimens. METHOD This article introduces a number of psychological concepts that relate to adherence and that can be leveraged by mHealth. Elements that contribute to flow (optimal experience) during an activity and those that reinforce grit (perseverance to achieve a long-term goal) can be used to engage patients in their own rehabilitation. RESULTS The experience of flow can be targeted by presenting the rehabilitation exercise as an optimally challenging game, one that offers a match between challenge and ability. Grit can be supported by reinforcing routine and by varying the therapy experience using different games. CONCLUSIONS A combination of hardware and software design approaches have the potential to transform uninteresting and repetitive activities, such as those that make up swallowing therapy regimens, into engaging ones. The field of gamification, however, is still developing, and gamified mHealth apps will need to withstand scientific testing of their claims and demonstrate effectiveness in all phases of outcome research.
Collapse
Affiliation(s)
- Gabriela Constantinescu
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Jana Rieger
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Kerry Mummery
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - William Hodgetts
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, Canada
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| |
Collapse
|
24
|
Burns CL, Kularatna S, Ward EC, Hill AJ, Byrnes J, Kenny LM. Cost analysis of a speech pathology synchronous telepractice service for patients with head and neck cancer. Head Neck 2017; 39:2470-2480. [DOI: 10.1002/hed.24916] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/24/2017] [Accepted: 07/13/2017] [Indexed: 12/11/2022] Open
Affiliation(s)
- Clare L. Burns
- Speech Pathology and Audiology Department; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- The University of Queensland; School of Health and Rehabilitation Sciences; Brisbane Queensland Australia
- Centre for Research Excellence in Telehealth; The University of Queensland; Brisbane Queensland Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation; Queensland University of Technology; Brisbane Queensland Australia
| | - Elizabeth C. Ward
- The University of Queensland; School of Health and Rehabilitation Sciences; Brisbane Queensland Australia
- Centre for Research Excellence in Telehealth; The University of Queensland; Brisbane Queensland Australia
- Centre for Functioning and Health Research, Metro South; Brisbane Queensland Australia
| | - Anne J. Hill
- The University of Queensland; School of Health and Rehabilitation Sciences; Brisbane Queensland Australia
- Centre for Research Excellence in Telehealth; The University of Queensland; Brisbane Queensland Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics; Menzies Health Institute Queensland, Griffith University; Brisbane Australia
| | - Lizbeth M. Kenny
- Central Integrated Regional Cancer Services; Brisbane Queensland Australia
- School of Medicine; The University of Queensland; Brisbane Queensland Australia
- Cancer Care Services; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
| |
Collapse
|
25
|
Burns CL, Ward EC, Hill AJ, Kularatna S, Byrnes J, Kenny LM. Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: Evaluation of service outcomes. Head Neck 2017; 39:932-939. [PMID: 28225567 DOI: 10.1002/hed.24706] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/04/2016] [Accepted: 12/09/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The purpose of this study was to present our evaluation of a new speech pathology telepractice service supporting the swallowing and communication management of patients with head and neck cancer. METHODS A multicenter randomized controlled trial was conducted within a large public cancer service. Referrals from speech pathologists at 3 regional sites (spoke sites) were managed by a specialist clinician from a cancer center (hub site) either via standard care (phone/email support/appointments at the hub site) or a newly established telepractice service (online consultation between the hub site and spoke site). RESULTS Eighty-two referrals (39 for standard care and 43 for telepractice care) were managed. Service efficiency favoring the telepractice model was reported with a significant reduction in the number (p = .004) and duration (p = .024) of contact events required to manage the referrals. Higher consumer and clinician satisfaction was also reported for the telepractice service. CONCLUSION A speech pathology telepractice service benefits both the patient and health provider through higher service efficiency and treatment satisfaction. © 2017 Wiley Periodicals, Inc. Head Neck 39: 932-939, 2017.
Collapse
Affiliation(s)
- Clare L Burns
- Speech Pathology and Audiology Department, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.,Centre for Research Excellence in Telehealth, The University of Queensland, Brisbane, Queensland, Australia
| | - Elizabeth C Ward
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.,Centre for Research Excellence in Telehealth, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Functioning and Health Research, Metro South, Brisbane, Queensland, Australia
| | - Anne J Hill
- The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia.,Centre for Research Excellence in Telehealth, The University of Queensland, Brisbane, Queensland, Australia
| | - Sanjeewa Kularatna
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Lizbeth M Kenny
- Central Integrated Regional Cancer Services, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| |
Collapse
|
26
|
Implant supported dental rehabilitation following segmental mandibular reconstruction- quality of life outcomes of a prospective randomized trial. J Craniomaxillofac Surg 2016; 44:800-10. [DOI: 10.1016/j.jcms.2016.04.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 03/08/2016] [Accepted: 04/06/2016] [Indexed: 11/24/2022] Open
|
27
|
Namin AW, Varvares MA. Functional outcomes of sensate versus insensate free flap reconstruction in oral and oropharyngeal reconstruction: A systematic review. Head Neck 2016; 38:1717-1721. [DOI: 10.1002/hed.24494] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 02/13/2016] [Accepted: 03/22/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
- Arya W. Namin
- Department of Surgery; University of Texas Southwestern Medical Center; Dallas Texas
| | - Mark A. Varvares
- Department of Otolaryngology - Head and Neck Surgery; Massachusetts Eye and Ear Infirmary and Department of Otology and Laryngology; Harvard Medical School; Boston Massachusetts
| |
Collapse
|
28
|
Roman BR, Goldenberg D, Givi B. AHNS Series-Do you know your guidelines? Guideline recommended follow-up and surveillance of head and neck cancer survivors. Head Neck 2016; 38:168-74. [DOI: 10.1002/hed.24100] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 04/16/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
- Benjamin R. Roman
- The Education Committee of American Head and Neck Society (AHNS) and Head and Neck Service; Memorial Sloan Kettering Cancer Center; New York New York
| | - David Goldenberg
- The Education Committee of American Head and Neck Society (AHNS) and Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University; College of Medicine; Hershey Pennsylvania
| | - Babak Givi
- The Education Committee of American Head and Neck Society (AHNS) and Department of Otolaryngology; New York University Langone Medical Center; New York New York
| | | |
Collapse
|
29
|
Abstract
Oral cavity squamous cell carcinoma (OC-SCC) is the most common malignancy of the head and neck (excluding nonmelanoma skin cancer). Recent trends have shown a dramatic rise in the incidence of oropharyngeal squamous cell carcinoma (OP-SCC), with a marked increase in lesions related to human papillomavirus infection. This update presents the latest evidence regarding OC-SCC and OP-SCC. In particular, the authors compare and contrast tumors at these two sites with respect to epidemiology, etiopathogenesis, clinicopathologic presentation, clinical assessment, imaging, management, and prognosis. It is important for clinicians to be aware of differences between OC-SCC and OP-SCC so that appropriate patient education and multidisciplinary care can be provided to optimize outcomes.
Collapse
Affiliation(s)
- Angela C Chi
- Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
| | - Terry A Day
- Professor, Wendy and Keith Wellin Endowed Chair for Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Brad W Neville
- Distinguished University Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
| |
Collapse
|
30
|
Rosenthal DI, Mohamed ASR, Weber RS, Garden AS, Sevak PR, Kies MS, Morrison WH, Lewin JS, El-Naggar AK, Ginsberg LE, Kocak-Uzel E, Ang KK, Fuller CD. Long-term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: A 3-decade survey. Cancer 2015; 121:1608-19. [PMID: 25586197 DOI: 10.1002/cncr.29241] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/20/2014] [Accepted: 11/24/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND The current study was conducted to evaluate long-term disease control, survival, and functional outcomes after surgical and nonsurgical initial treatment for patients with T4 larynx cancer. METHODS Demographics, disease stage, and treatment characteristics were reviewed for 221 sequential patients treated for T4 laryngeal squamous cell cancer at a single institution between 1983 and 2011. Survival and disease control outcomes were calculated. RESULTS The median follow-up time was 47 months (71 months for patients still alive at the time of analysis). The overall 5-year and 10-year overall survival rates were 52% and 29%, respectively, and the corresponding disease-free survival rates were 57% and 48%, respectively. Overall 5-year and 10-year locoregional control rates were 78% and 67%, respectively, and the corresponding rates for freedom from distant metastasis were 76% and 74%, respectively. On both univariate and multivariate analyses, lymph node-positive disease at the time of presentation was associated with overall mortality (P<.0001). Patients treated with laryngectomy followed by postlaryngectomy radiotherapy (161 patients) achieved better initial locoregional control than patients treated with a laryngeal preservation (LP) approach (60 patients) throughout the follow-up period (log-rank P<.007) yet the median overall survival times were equal for both groups (64 months; 95% confidence interval 47-87 months and 38-87 months, respectively [P =.7]). Patients treated with an LP approach had a tracheostomy rate of 45% and an any-event aspiration rate of 23%. Rates of high-grade dysphagia at the time of last follow-up were worse for patients treated with an LP approach (P<.01). CONCLUSIONS Surgery and postoperative radiotherapy can produce substantial long-term cancer control and survival rates for patients with T4 larynx cancer. Caution should be taken when selecting patients for initial nonsurgical treatment because of significant rates of functional impairment despite survival equivalence.
Collapse
Affiliation(s)
- David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Current assessment and treatment strategies of dysphagia in head and neck cancer patients. Curr Opin Support Palliat Care 2014; 8:152-63. [DOI: 10.1097/spc.0000000000000050] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|