Cough strength and expiratory force in aspirating and nonaspirating postradiation head and neck cancer survivors

Hutcheson, Katherine A.; Barrow, Martha P.; Warneke, Carla L.; Wang, Yudong; Eapen, George A.; Lai, Stephen Y.; Barringer, Denise A.; Plowman, Emily K.; Lewin, Jan S.

doi:10.1002/lary.26986

Cited by 29 publications

(19 citation statements)

References 22 publications

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“…Since this monograph describes only the first‐year's outcomes (i.e., a single clinic visit per patient), data demonstrating a functional benefit or improvement in outcomes associated with participation in rehabilitation efforts are unavailable. Cancer rehabilitation is widely recognized as an essential element of survivorship and utilizes interventions that can improve, maintain, restore, or compensate for dysfunction 4,7,37,60,72‐78 . Nevertheless, repeating PRO and functional measures for patients who attend this clinic over time would provide novel information regarding beneficial effects.…”

Section: Discussionmentioning

confidence: 99%

“…Cancer rehabilitation is widely recognized as an essential element of survivorship and utilizes interventions that can improve, maintain, restore, or compensate for dysfunction. 4,7,37,60,[72][73][74][75][76][77][78] Nevertheless, repeating PRO and functional measures for patients who attend this clinic over time would provide novel information regarding beneficial effects. In view of the preliminary effectiveness of this interdisciplinary clinic, we continue to employ this model at our institution; in addition, we are initiating a prospective multiyear study examining the efficacy of this interdisciplinary functional surveillance model.…”

Section: Discussionmentioning

confidence: 99%

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Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

et al. 2021

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Background Identifying and treating late dysfunction in survivors of head and neck cancer (HNC) is important; however, an effective way to do so is not established. Methods A quality improvement initiative altering our HNC survivorship clinic to include surveillance by rehabilitation providers was undertaken. The nature of dysfunction identified, along with the number and type of referrals to ancillary/support services were collected and compared to baseline. Results The baseline, single‐provider, clinic evaluated 61 patients and referred 2 (3%) to ancillary/support services. Fifty‐seven patients were evaluated in the interdisciplinary clinic, with 36 (63%) referred to at least one ancillary/support service for new/progressive dysfunction. Of 59 referrals made, 22 (37%) were for dysphagia, 17(29%) were for neck/shoulder dysfunction, and 28 (47%) were attended by the patient. Conclusion Many HNC survivors exhibit late dysfunction appropriate for referral to ancillary/support services. A survivorship clinic including surveillance by rehabilitation specialists may optimize identification of dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

et al. 2021

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“…Si bien en esta revisión no fueron considerados aquellos ejercicios o métodos que no han reportado efectividad en estudios experimentales, es importante señalar el caso del Entrenamiento de Fortalecimiento de la Musculatura Espiratoria (EMST, por su sigla en inglés), el cual apunta a fortalecer las fuerzas generadoras de fuerza espiratoria subglótica, lo que favorecería la protección de la vía aérea (cierre y producción de tos más eficiente), favoreciendo la eliminación de residuos en vía aérea, lo cual es considerado como prometedor en su aplicación a este tipo de usuarios, incluidos aquellos con disfagias crónicas 14 , pero requiere de evidencia más consistente para poder ser reafirmado.…”

Section: Calidad De Vidaunclassified

“…A lo anterior, se suma la atrofia por desuso, que estimula una remodelación adversa de los músculos del tracto aerodigestivo 12 , incrementando el riesgo de aspiración sintomática y silente de los alimentos, en este último grupo 13 . Otra de las funciones afectadas tiene relación con la disminución de fuerza espiratoria (PEmax y PeakFlow Tos) en pacientes con CCC posradiación, lo que sugiere que las alteraciones de la protección de las vías respiratorias pueden extenderse más allá de los mecanismos laringofaríngeos alterados en el campo de tratamiento local 14 .Todas estas alteraciones conllevan un impacto en el proceso deglutorio general. La disminución en la retracción de la base de la lengua y constrictores faríngeos, resulta en un declive de la propulsión del bolo alimenticio hacia la faringe y una disminución de la elevación laríngea al deglutir, paralelo a una reducción del movimiento de basculación de la epíglotis, generando como consecuencia, un riesgo elevado de residuos en valléculas y senos piriformes o falsa vía después de la deglución, lo cual evidencia una relajación incompleta del esfínter cricofaríngeo 15,16 .…”

Section: Introductionunclassified

Estrategias profilácticas para disfagia orofaringea en pacientes con cáncer de cabeza y cuello: revisión narrativa

Morales

Esparza

2020

Rev Cient Cien Med

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El cáncer de cabeza y cuello es una patología prevalente a nivel mundial. Su abordaje consiste, en buena partede los casos, de quimiorradioterapia, la cual, dentro de sus múltiples consecuencias, comprometelaanatomíayelfuncionamiento de órganosrelacionadas a la deglución, generando disfagia orofaríngea. En ese sentido, el manejofonoaudiológico predominantemente se lleva a cabo con ejercicios implementados posterior a la manifestaciónde la disfagia, con creciente interés sobre el manejo profiláctico del cuadro, existiendo variados estudios sobre lautilidad de ejercicios y maniobras relacionadas. En consecuencia, el objetivo de la presente revisión es presentarrecursos terapéuticos basados en evidencia de calidad para el manejo proactivo de esta alteración, orientando ladecisión clínica sobre su uso.

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“…Given the shared anatomical and neural substrates of cough and swallowing function, the relationships between dystussia and dysphagia have been the subject of recent clinical research (4,(11)(12)(13)(14)(15). Indeed, the utility of voluntary cough testing to serve as a clinical assay for the identification of dysphagia has been examined within several patient populations, including ALS (4,11,(16)(17)(18). Although it is known that individuals with ALS demonstrate poor airway defense physiologic capacity and secretion management that is attributed, in part, to impaired cough effectiveness (5); no study has comprehensively examined aberrant features of ALS cough airflow patterns in comparison to healthy age and gender-matched individuals.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of impaired voluntary cough function in individuals with amyotrophic lateral sclerosis

Gray

Gallestagui

Vasilopoulos

et al. 2019

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Objective.-Although cough impairment (dystussia) is common in individuals with amyotrophic lateral sclerosis (ALS) and contributes to a reduced physiologic capacity to defend the airway, characteristics of dystussia have not yet been delineated. We therefore aimed to compare voluntary cough spirometry airflow patterns between individuals with ALS and healthy age and gender matched controls.Methods.-Thirty-two individuals with a diagnosis of probable-definite ALS (El-Escorial Criterion) and 29 healthy age and gender-matched controls underwent voluntary cough spirometry testing. Two blinded raters derived six objective voluntary cough airflow measures including: peak inspiratory phase duration, peak inspiratory flow rate, compression phase duration, peak expiratory rise time, peak expiratory flow rate, and cough volume acceleration. Independent samples t-tests with Cohen's d effect sizes were performed between Healthy vs. ALS groups for cough metrics (alpha=0.05).Results.-ALS individuals demonstrated prolonged inspiratory phase and expiratory phase rise time durations, reduced inspiratory and expiratory flow rates, and lower cough volume acceleration during voluntary cough production compared to healthy controls (p< 0.05). No differences in compression phase duration were observed (p>0.05).Conclusions.-This study compared characteristics of voluntary cough airflow patterns of individuals with ALS to healthy-matched controls. Findings identified impairments in both inspiratory and expiratory voluntary cough airflow, resulting in slower, weaker, and thus less effectiveness voluntary cough production in ALS individuals. These data afford insight into the

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Cough strength and expiratory force in aspirating and nonaspirating postradiation head and neck cancer survivors

Abstract: 2b. Laryngoscope, 128:1615-1621, 2018.

Cited by 29 publications

References 22 publications

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

Estrategias profilácticas para disfagia orofaringea en pacientes con cáncer de cabeza y cuello: revisión narrativa

Characteristics of impaired voluntary cough function in individuals with amyotrophic lateral sclerosis

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