Swallow function and perception of dysphagia in patients with head and neck cancer

Pauloski, Barbara Roa; Rademaker, Alfred; Logemann, Jerilyn A.; Lazarus, Cathy L.; Newman, Lisa A.; Hamner, Annette; MacCracken, Ellen; Gaziano, Joy; Stachowiak, Linda

doi:10.1002/hed.10092

Cited by 148 publications

(135 citation statements)

References 39 publications

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“…Objective evaluation of swallowing correlated with some of the patients assessed symptoms. This has been described previously: Pauloski et al [27] made repetitive VF measurements in 132 patients and asked, ''Do you experience problems with swallowing?'' at the same time points.…”

Section: Discussionmentioning

confidence: 99%

Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer

et al. 2007

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“…Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications (anastomotic fistula, wound infections, and major complications such as septicemia) (Arriraga et al, 1990) and have several problems related to swallowing function and perception of dysphagia (Pauloski et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trial with an enteral arginine-enhanced formula in early postsurgical head and neck cancer patients

et al. 2004

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Objective: Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients using an arginineenhanced formula could improve nutritional variables as well as clinical outcomes. Design: Randomized clinical trial. Setting: Tertiary care. Subjects: A population of 90 patients with oral and laryngeal cancer was enrolled. Interventions: At surgery, patients were randomly allocated to two groups: (a) patients receiving an arginine-enhanced formula with arginine and fiber (group I) and (b) patients receiving an isocaloric, isonitrogenous formula with fiber enteral formula (group II). Results: No significant intergroup differences in the trend of the three plasma proteins (albumin, transferrin, prealbumin) and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) was better in group II than I (40% group I and 13% group II: Po0.05). The postoperative complications due to infections were similar in both groups (4% group I and 9% group II: ns). Fistula (wound complication) was less frequent in the enriched nutrition group (5% group I and 11% group II: Po0.05); wound infection was similar in both groups. The length of postoperative stay was better in group I than II (25.8715 days vs 35724.6 days; Po0.05). Conclusions: In conclusion, arginine-enhanced formula improves fistula rates in postoperative head and neck cancer patients and decreases length of stay.

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“…However, restrictions in oral intake have been previously associated with videofluoroscopic measures of reduced laryngeal excursion, reduced cricopharyngeal opening, and evidence of aspiration and/or residue [33]. In the current study, descriptive analysis revealed that the pharyngeal and crico-esophageal phases were impaired with slightly higher frequency in the CRT group, which may have resulted in greater texture restriction, perceived need for supplemental feeding and overall inferior functional swallowing.…”

Section: Resultsmentioning

confidence: 55%

Swallowing, nutrition and patient-rated functional outcomes at 6 months following two non-surgical treatments for T1–T3 oropharyngeal cancer

Cartmill

Cornwell

Ward

et al. 2011

Support Care Cancer

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Purpose: Altered fractionation radiotherapy with concomitant boost (AFRT-CB) may be considered an alternative treatment for patients not appropriate for chemoradiation (CRT). As functional outcomes following AFRT-CB have been minimally reported, this exploratory paper describes the outcomes of patients managed with AFRT-CB or CRT at 6 months post treatment.Methods: Using a cross-sectional analysis design, functional outcomes of 14 AFRT-CB and 17 CRT patients with T1-T3 oropharyngeal cancers were explored at 6 months post-treatment. Clinical and instrumental swallow assessments, weight and nutritional status, and the functional impact of treatment were examined.Results: Inferior outcomes were observed for the CRT patients on the RBHOMS (p = 0.03) which was reflected in diet and fluid restrictions with 18% of the CRT group requiring modified fluids and diets.Although a trend (p = 0.07) was noted for increased lingual deficits and aspiration risk for fluids in the CRT group, no other significant differences were observed. Both groups experienced an average of 10kg weight loss and reported reduced general and swallowing related function. Conclusions:This preliminary data suggests functional outcomes following AFRT-CB and CRT were largely comparable at 6 months post treatment. Treatment intensification in any form may contribute to impaired function which requires multidimensional intervention. Larger cohort investigations with systematic methodology are needed to further examine these initial findings.Keywords: swallowing, nutrition, oropharyngeal cancer, chemoradiation, altered fractionation radiotherapy This paper aims to inform research by providing further evidence for functional outcomes following non-surgical treatment for head and neck cancer.

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Swallow function and perception of dysphagia in patients with head and neck cancer

Cited by 148 publications

References 39 publications

Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer

Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer

Randomized clinical trial with an enteral arginine-enhanced formula in early postsurgical head and neck cancer patients

Swallowing, nutrition and patient-rated functional outcomes at 6 months following two non-surgical treatments for T1–T3 oropharyngeal cancer

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