This study prospectively evaluated relationships between oral morbidities and swallowing ability in head/neck cancer patients following chemoradiation therapy (CRT) and at 3 months following CRT. Thirty patients with confirmed head/neck cancer undergoing chemoradiation were assessed with a battery of swallowing measures and measures of oral morbidities related to chemoradiation (xerostomia, mucositis, pain, taste/smell, oral moisture). All measures were completed at baseline (within the first week of CRT), at 6 weeks (end of treatment), and at 3 months following chemoradiation. Descriptive and univariate statistics were used to depict change over time in swallowing and each oral morbidity. Correlation analyses evaluated relationships between swallowing function and oral morbidities at each time point. Most measures demonstrated significant negative change at 6 weeks with incomplete recovery at 3 months. At 6 weeks, mucositis ratings, xerostomia, and retronasal smell intensity demonstrated significant inverse relationships with swallowing function. In addition, oral moisture levels demonstrated significant positive relationships with swallowing function. At 3 months, mucositis ratings maintained a significant, inverse relationship with swallow function. Taste and both orthonasal and retronasal smell intensity ratings demonstrated inverse relationships with measures of swallow function. Swallow functions and oral morbidities deteriorate significantly following CRT with incomplete recovery at 3 months post treatment. Furthermore, different patterns of relationships between swallow function measures and oral morbidities were obtained at the 6-week versus the 3-month assessment point suggesting that different mechanisms may contribute to the development versus the maintenance of dysphagia over the trajectory of treatment in these patients.

Objective: Treatment of tongue cancer caused oral morbidities such as oral dryness, and dysphagia. The purpose of this study is to examine the time course of oral function and QOL based on resected area for patients after tongue cancer resection. Methods: 31 patients who underwent tongue cancer resection at the Showa University Head and Neck Oncology Center. The participants were divided into two groups; 24 participants in partial/hemi glossectomy group (PG), and seven in subtotal/total glossectomy group (TG). Participants were evaluated swallowing function (FOIS and MASA-C), tongue pressure (TP: kPa), BMI, whole body muscle mass (kg), and QOL evaluation (EORTC QLQ-C30, H & N35). Participants were measured at baseline (before surgical treatment), 1, 3, and 6 months after surgical treatment (1M, 3M, and 6M). Results: At baseline, tongue pressure and FOIS score of PG were significant higher than that of TG. At 1M, TP, MASA-C, and FOIS score of PG were significant higher than that of TG. At 3M, TP, MASA-C, and FOIS score of PG were significant higher than that of TG. At 6M, TP and MASA-C were significantly higher than that of TG. QOL measurements did not noted any significant difference between groups before 6M. At 6M, Some QOL measurements of TG related tongue function (Swallowing, Senses, Speech, Social contact) were significantly lower than PG. Conclusions: The resected area had significant effects on oral morbidities and feeding function. It is necessary to develop more effective rehabilitation methods to improve patients QOL who had functional impairment remained.

Several studies have investigated the accuracy of cervical auscultation (CA). However, both the sensitivities and the specificities of CA in detecting dysphagic conditions varied widely among these studies. These wide variations of the accuracy of CA might be caused by differences of the targeted sounds, such as the expiratory sound (ES) and/or swallowing sound (SS). Forty‐six dysphagic patients were served as subjects. Patients who had unoccluded tracheostoma and patients who could not follow the instructions were excluded. During the videofluorographic swallowing study (VFSS), the subjects swallowed 3 ml of yogurt containing barium sulfate. The VFSS images were recorded with acoustic signals including both the swallowing and respiratory sounds detected by our method. Classification of the VFSS images was decided by consensus of the three dentists using a penetration‐aspiration scale (PAS). Recorded VFSS images were classified into the following 2 groups based on PAS: “no or minimum risk group”: PAS1–2; and “possible risk group”: PAS3–8. As a result of the classification of VFSS findings, 30 samples were evaluated as no or minimum risk group and 16 as possible risk group. Twelve observers including 10 dentists other than 3 dentists who evaluated VFSS images and 2 speech pathologists auditorily diagnosed “negative” and “positive.” Sensitivity, specificity, and intra‐rater reliability was calculated for the 3 types of acoustic samples. The sensitivity of the intra‐rater reliability was 60.3% for ES, 76.6% for SS, and 89.9% for ES + SS. The sensitivity of intra‐rater reliability of ES + SS samples was significantly higher than that of ES (p < .01) and SS (p < .05). The sensitivity of intra‐rater reliability of SS was significantly higher than that of ES (p < .01). The specificity of the intra‐rater reliability was 53.7% for ES, 50.3% for SS, and 44.5% for ES + SS. ES + SS might be most useful for detecting the presence of material in the airway.

This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty-nine patients with complaints of swallow difficulty received a videofluorographic (VF) examination. They were divided into three groups: nine who did not have any apparent disease (Group N), 22 patients with head and neck cancer (Group H&N) and 18 patients with other diseases including cerebrovascular disease (Group OD). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal (Normal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one-third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0-Hz band was chosen as the reference band level (RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0-Hz band was set as the critical value to differentiate dysphagia (Resid or Pen/Asp) from no dysphagia (Normal or Acceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post-swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups.