Oropharyngeal Dysphagia Evaluation Tools in Adults with Solid Malignancies Outside the Head and Neck and Upper GI Tract: A Systematic Review

Abstract

Dysphagia is often associated with head and neck and upper gastrointestinal (GI) tract cancers. Evidence suggests that those with solid malignancies in other primary sites may also have swallowing difficulties. Timely and accurate identification of dysphagia is important given the impact it has on hydration, medical treatment, nutrition, prognosis, and quality of life. A systematic review was conducted to identify swallow screening, evaluation, and quality of life tools for those with solid malignancies outside the head and neck and upper GI tract. Ten electronic databases, one journal and two published conference proceedings were searched. Following deduplication, 7435 studies were examined for relevance. No tools were validated solely in this cancer population, though some included this group in larger cohorts. Comments are provided on the diagnostic properties and applicability of these tools. In the absence of appropriate diagnostic instruments, the exact prevalence of dysphagia and its impact on clinical and psychosocial well-being remain unknown. Accurate and adequate measurement of therapeutic intervention is also compromised. This review establishes the need for validated dysphagia evaluation tools for this clinical population.

Dysphagia Prevalence and Predictors in Cancers Outside the Head, Neck, and Upper Gastrointestinal Tract

“…These are quick to administer, nonburdensome for participants, and based on best available evidence. 74…”

“…This was adapted from another study, 73 which was found to be a good dysphagia screen. 74 A question about chewing difficulties was added because dysphagia diagnosis includes masticatory difficulties. A third about ''being more aware of your swallow'' was added in case dysphagia was subclinical.…”

Textural characteristics of safe dishes for dysphagic patients: a multivariate analysis approach

“…Dysphagia is the difficulty in swallowing in initial phases (oropharyngeal dysphagia) or the obstruction sensation when the solids and liquids are moving from the mouth to the stomach (esophageal dysphagia). The groups of people most affected are the elderly people, more than 50% of institutionalized elderly population, [1] as well as 60-75% of the patients who undergo radiotherapy for head and neck cancer, [2] and up to 80% of people with neurodegenerative diseases. [3] In some hospitals or geriatrics, 75% of elderly people have nutritionals problems because the oropharyngeal dysphagia is not correctly diagnosed or the diet is not fit for their requirements.…”

Revisión sistemática para el abordaje de síntomas desagradables gastrointestinales en cuidados paliativos

“…En la Tabla 2, se presenta los tipos de artículos que se seleccionaron que fueron 3 como son descriptivos, analíticos y experimentales en el rango de las fechas de publicación de los artículos y las cantidades obtenidas en total, se realiza un agregado de los autores que se tuvieron en cuenta con más de una publicación pero que fuera un estudio totalmente diferente. El rol que enfrenta el enfermero en este campo aun no es claro y tiene el reto de identificar su rol en un equipo interdisciplinar y ser partícipe del control de los síntomas, asegurándose de las necesidades individuales, concretas y específicas en continuo cambio y evolución del paciente y su familia, fomentando la autonomía y los derechos de la persona y ofrecer acompañamiento, respetando sus valores, creencias y estilos de vida, siempre en pro del confort, bienestar y calidad de vida 58 .…”