Deliberações clínicas na atuação  em pacientes com câncer de cabeça e pescoço: atualidades e desafios na disfagia

Zica, Guilherme Maia; Freitas, Andressa Silva de

doi:10.23925/2176-2724.2019v31i4p693-697

Cited by 2 publications

(11 citation statements)

References 9 publications

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“…It is possible to understand that an unfavorable outcome and deficit in the functionality of the larynx still characterize a restricted prognosis of patients with the disease in its advanced stage, due to the loss or alteration of the voice and the presence of dysphagia that significantly compromises the quality of life (1,6) .…”

Section: Discussionmentioning

confidence: 99%

“…In laryngeal cancer, surgery must prove acceptable functional results in terms of voice and swallowing, to maintain and justify partial surgery (1,3,6) . Thus, a reconstruction that includes resection of the cricoid ring and hyoid bone in STL in minimally invasive transglottic tumors in the subglottis is, perhaps, a challenge for the rehabilitation team (1,6,7) .…”

Section: Discussionmentioning

confidence: 99%

“…In the clinical examination of the immediate postoperative period, a severe alteration in the mobility of the tongue was observed, being subsequently tractioned by the pexy at the base of the tongue. Some strategies become relevant, such as exercises for mobility and tongue strength, as well as the supraglottic and super-supraglottic maneuvers, which allow a greater range of motion and duration of closure of the laryngeal vestibule (1,3) .…”

Section: Presentation Of the Clinical Casementioning

confidence: 99%

“…The different forms of treatment developed in the 20th century have enhanced care and significantly increased the survival of patients with head and neck cancer (1,2) . Due to the negative outcomes resulting from the permanent loss of laryngeal voice, dysphagia and lower quality of life, organ preservation protocols do not indicate total laryngectomies (3) .…”

Section: Introductionmentioning

confidence: 99%

“…The most recurrent functional complications of horizontal open partial laryngectomies (SCL and STL) are related to respiratory and swallowing functions (1,3) . In cases whose resection is broader than that predicted by the surgical technique, as in already described cases of STL that remove part of the base of the tongue, adjacent tissue or arytenoid, the procedure of extended, enlarged or modified STL is named (2,(6)(7)(8)(9) .…”

Section: Introductionmentioning

confidence: 99%

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Reconstrução atípica de laringe: avaliação funcional pós-laringectomia supratraqueal ampliada com cricoglossohioidopexia

Zica

Santos

Dias

et al. 2021

Audiol., Commun. Res.

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RESUMO Em tumores transglóticos estendidos para base de língua, a indicação para ressecção do osso hioide descarta a possibilidade de realização de uma laringectomia parcial horizontal clássica, devido ao grande risco de complicações pulmonares oriundas de uma disfagia grave. O objetivo deste estudo foi descrever os aspectos funcionais de deglutição e voz de um paciente submetido à laringectomia supratraqueal ampliada com cricoglossohioidopexia. Trata-se de um homem de 69 anos, com tumoração transglótica na hemilaringe direita, submetido à laringectomia supratraqueal ampliada, com ampliação para base de língua, osso hioide e aritenoide direita. Na videofluoroscopia da deglutição, observou-se aspiração silente para líquido fino durante a deglutição e resíduo em base de língua, valécula, aritenoide, esfíncter esofágico superior e recessos piriformes em todas as consistências e volumes. Na videolaringoscopia, observou-se voz por meio da vibração da unidade cricoaritenóidea esquerda, associada à base de língua e constritores da faringe. No protocolo Consensus Auditory-Perceptual Evaluation of Voice (CAPE V), notou-se grau moderado de rouquidão e soprosidade. O paciente apresentou preservação parcial das funções laríngeas, grau moderado de disfonia e alimentação e hidratação exclusivas por via oral, com sólidos macios e líquido espessado em néctar, sem prejuízos à saúde pulmonar, até o momento.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Presentation Of the Clinical Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reconstrução atípica de laringe: avaliação funcional pós-laringectomia supratraqueal ampliada com cricoglossohioidopexia

Zica

Santos

Dias

et al. 2021

Audiol., Commun. Res.

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DIGEST Scale Predictis More Quality of Life Than PAS: The Residue Influence on Supracricoid Laryngectomy

Freitas

Zica

Salles

et al. 2021

Int Arch Otorhinolaryngol

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Introduction Supracricoid laryngectomy (SCL CHEP) removes ∼ 70% of the larynx, resulting in structural rearrangement and modification of the swallowing mechanism, promoting chronic dysphagia. One of the consequences of this new physiology is the formation of pharyngeal residues that can increase the possibility of aspiration. The formation of residues after SCL CHEP, its functional consequences, and its influence on quality of life (QOL) is still poorly described in the literature. Objective To investigate and compare the association between self-reported QoL and objective assessments of swallowing function in patients undergoing SCL CHEP. Methods A cross-sectional study was performed from 2018 to 2020 in a reference service for head and neck surgery in Brazil. A total of 860 swallowing videofluoroscopy images were evaluated using the Penetration and Aspiration Scale (PAS) and Dynamic Imaging Grade of Swallowing Toxicity (DIGEST). Results In a group of 86 patients, there was a significant relationship between oncological staging and the global (p < 0.001) and total (p = 0.002) QoL domains. There was a negative correlation between the DIGEST scale and the emotional domain of the QoL protocol (p = 0.045). The swallowing function proved to be relevant for QoL. Conclusion The PAS scale did not show any correlation with QoL. The functional performance of swallowing according to the DIGEST scale was coherent with the QOL scores. It is suggested that the residue may be a more relevant aspect for QoL than the aspiration, making DIGEST a promising tool in the assessment of dysphagic patients.

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Deliberações clínicas na atuação em pacientes com câncer de cabeça e pescoço: atualidades e desafios na disfagia

Abstract: Starmer H, Edwards J. Clinical Decision Making with Head and Neck Cancer Patients with Dysphagia. Semin Speech Lang. 2019 Jun;40(3):213-226.

Cited by 2 publications

References 9 publications

Reconstrução atípica de laringe: avaliação funcional pós-laringectomia supratraqueal ampliada com cricoglossohioidopexia

Reconstrução atípica de laringe: avaliação funcional pós-laringectomia supratraqueal ampliada com cricoglossohioidopexia

DIGEST Scale Predictis More Quality of Life Than PAS: The Residue Influence on Supracricoid Laryngectomy

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