Predictors of chewing and swallowing disorders after surgery for locally advanced oral cancer with free flap reconstruction: A prospective, observational study

Ohkoshi, Akira; Ogawa, Takenori; Nakanome, Ayako; Ishida, Eiichi; Ishii, Ryo; Kato, Kengo; Katori, Yukio

doi:10.1016/j.suronc.2018.05.029

Cited by 32 publications

(22 citation statements)

References 17 publications

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“…Overall, the most important variables influencing deglutition were adjuvant treatment, age, gender, oropharyngeal resection, and type of free flap employed, as previously reported in literature. [19][20][21][22][23] Performing functional evaluation at 6 and 12 months showed that it is reasonable to expect some improvements up to 1 year after surgery, as also confirmed by other studies. [24][25][26][27] It is interesting to note how at 1 year after treatment patients' subjective perception of swallowing is generally reported as good/satisfactory in more than 50% of cases using both the EORTC and UWQOL questionnaires.…”

Section: Discussionsupporting

confidence: 79%

“…Furthermore, most authors report significant deterioration of speech and swallowing only in patients requiring resections wider than an hemiglossectomy, thus involving the contralateral tongue compartment or the mandible. 17,21,23 In this view, when appropriately indicated, CTS for OTFOMSCC has the potential to offer superior oncologic results without significantly reducing functional outcomes compared to conventional partial glossectomy.…”

Section: Discussionmentioning

confidence: 99%

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Compartmental Surgery for Oral Tongue Cancer: Objective and Subjective Functional Evaluation

et al. 2020

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Objective: To assess functional outcomes in patients treated by compartmental tongue surgery (CTS) and reconstruction for advanced oral tongue/floor-of-mouth cancer. Study Design: Retrospective case series. Methods: A retrospective cohort of patients (n = 48) treated by CTS and free flap reconstruction was prospectively evaluated concerning postoperative functional outcomes at different time points (6 months and 1 year). Swallowing was studied by videonasal endoscopic evaluation (VEES) and videofluoroscopy (VFS), testing various food consistencies and grading the results with the Donzelli scale. Speech articulation, lingual strength, and endurance were studied by phone call and Iowa Oral Performance Instrument (IOPI). Subjective tests (EORTC H&N35 and UWQOL) were administered. Results: After 1 year, VEES showed a Donzelli scale of 67% level 1, 23% level 2, and 10% level 3. Vallecular pouch was present in 81% of patients. VFS showed levels 1, 2, and 3 in 42%, 25%, and 33%, respectively, with liquids (L); 48%, 19%, and 33%, with semi-liquids (SL); and 54%, 33%, and 13%, with semi-solids (SS). Vallecular pouch residue was present in 69% with L, 73% with SL, and 87% with SS. The mean number of words recognized at phone call was 56 of 75 (range, 27-74). IOPI showed a mean tongue strength of 19.2 kPa (range, 0-40), and a mean endurance of 16.2 seconds (range, 0-60). Conclusion: CTS does not significantly affect speech. Sub-clinical food aspiration and vallecular pouch are present in a significant proportion of patients, especially when adjuvant treatments are administered. Residual tongue strength is not affected when proper reconstruction is performed.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Compartmental Surgery for Oral Tongue Cancer: Objective and Subjective Functional Evaluation

et al. 2020

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“…Surgical resections interrupting the floor-of-mouth or suprahyoid musculature and those necessitating flap reconstruction come with increased risk of aspiration and extended length of recovery, as opposed to a small, focal, oral resection with a primary closure or locally advanced tissue flap. [39][40][41] In patients deemed high risk for pulmonary complications arising from aspiration (e.g., those with chronic obstructive pulmonary disease), clinicians might also consider baseline pulmonary measures such as vital capacity, peak expiratory pressure, and cough reflex testing. 42 While humble, a simple peak flow meter and disposable filters can be a meaningful addition to the dysphagia clinician's toolset.…”

Section: Slp Management Of the Surgical Head And Neck Cancer Patientmentioning

confidence: 99%

Clinical Decision Making with Head and Neck Cancer Patients with Dysphagia

Starmer¹,

Edwards²

2019

Semin Speech Lang

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Dysphagia is a common challenge faced by patients with head and neck cancer. Management of these patients is quite distinct from many other dysphagia etiologies due to the nature of surgical removal of organs critical to swallowing, the ability to provide preventative therapies, and the variable risk for complications related to dysphagia. Thus, clinicians providing care to the head and neck cancer population need to understand these differences when employing clinical decision making. In addition, changes in the demographics of head and neck cancer, related predominantly to the epidemic of oropharyngeal cancer associated with the human papillomavirus, have further transformed both the types of patients and the types of treatments offered. These epidemiologic factors further complicate the decision-making process for clinicians. This article provides a framework for decision making in the surgical and nonsurgical patient with head and neck cancer.

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“…Whereas direct invasion of tumor to the pharynx causes a delayed swallowing reflex, the disappearance of tumor with treatment can improve swallowing function (8,9). Although there are many reports comparing swallowing function before and after treatment, few studies have focused on the latency of the swallowing reflex (10,11). Thus, a retrospective study of patients with advanced head and neck cancer was conducted to clarify the changes of the latency of the swallowing reflex from before to after treatment.…”

Section: Introductionmentioning

confidence: 99%

Improvement of a Delayed Swallowing Reflex with Treatment in Advanced Head and Neck Cancer Patients

Ohkoshi

Kato

Ogawa

et al. 2020

Preprint

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Background The latency of the swallowing reflex is an important factor causing dysphagia in head and neck cancer patients. Although there are many reports comparing swallowing function before and after treatment, few studies have focused on the latency of the swallowing reflex. The aim of this retrospective study was to clarify the changes in the latency of the swallowing reflex before and after treatment. Methods The latency of the swallowing reflex was quantified using the time from the injection of 1 ml of distilled water into the pharynx through a nasal catheter to the onset of swallowing. Results The latency time of the swallowing reflex was significantly decreased 3 months after treatment compared to before treatment. Significant reduction was also observed in patients with pharyngeal cancer who underwent chemoradiation therapy. Conclusions This retrospective study showed that a delayed swallowing reflex improved with treatment in advanced head and neck cancer patients.

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Predictors of chewing and swallowing disorders after surgery for locally advanced oral cancer with free flap reconstruction: A prospective, observational study

Cited by 32 publications

References 17 publications

Compartmental Surgery for Oral Tongue Cancer: Objective and Subjective Functional Evaluation

Compartmental Surgery for Oral Tongue Cancer: Objective and Subjective Functional Evaluation

Clinical Decision Making with Head and Neck Cancer Patients with Dysphagia

Improvement of a Delayed Swallowing Reflex with Treatment in Advanced Head and Neck Cancer Patients

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