Purpose of Review
To provide an overview of current concepts and considerations in the measurement of dysphagia-related quality of life (QoL) for people with head and neck disease. We describe key psychometric and other tool properties that are important to consider when deciding which dysphagia QoL tool to use in practice. The review seeks to establish which tool/s best meet the required properties.
Recent Findings
Currently, no single dysphagia QoL tool meets all criteria. However, a few (SWAL QoL, MDADI, SOAL) meet several parameters and we highlight the current evidence base for these assessments.
Summary
QoL is essential to providing holistic clinical care and could also be an important outcome in research when evaluating interventions. Existing tools may benefit from re-validation studies which take account of progress made in the fields of instrument development, cross-cultural validity and patient centredness. It is also crucial to recognise that the value of capturing QoL in clinical practice is only realised by subsequent follow-up with the individual patient.
Background: Dysphagia is a common consequence of tongue cancer and its treatment, with the possibility of long-term diet modification and feeding tube dependence. This is likely to have an impact on the activity, participation and psychological wellbeing of the individual. Objective: This case report presents the use of fiberoptic endoscopic evaluation of swallow (FEES) as a tool to support dysphagia rehabilitation through providing visual feedback following a salvage hemi-glossectomy for management of a recurrent squamous cell carcinoma (SCC) in the right anterolateral tongue. Methods: Clinician-rated and patient-reported outcome measures were used to assess the effectiveness of FEES as a tool to facilitate dysphagia rehabilitation. These measures include the: Performance Status Scale for Head and Neck (PSS-HN) cancer patients, 100 mL water swallow test (WST), Penetration-Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale, and the Functional Intraoral Glasgow Scale (FIGS). Results: No Statistical tests were performed on this single case, however the results demonstrate a notable clinical improvement in all postoperative outcome measures at 12-months when compared with those taken two-months postoperatively. Conclusion: Use of sequential FEES could enhance patient engagement and inform dysphagia rehabilitation following hemi-glossectomy.
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