Prognostic Factors for Swallowing Rehabilitation Following Head and Neck Cancer Surgery

• Published in: Acta oto-laryngologica 1997, Vol.117 (5), p.769-774
• Main Authors: Denk, Doris-Maria, Swoboda, Her Wig, Schima, Wolfgang, Eibenberger, Klemens
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aspiration; Biological and medical sciences; Deglutition Disorders - physiopathology; Deglutition Disorders - rehabilitation; Diseases of the upper aerodigestive tract; Endoscopy - methods; Ent and stomatology; Female; Fluoroscopy - methods; functional swallowing therapy; Head and Neck Neoplasms - surgery; head and neck surgical patients; Humans; Male; Medical sciences; Middle Aged; Neoplasm Staging; oropharyngeal dysphagia; Postoperative Complications - physiopathology; Postoperative Complications - rehabilitation; Prognosis; prognostic factors; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies
• ISSN: 0001-6489; 1651-2251
• DOI: 10.3109/00016489709113476

Thirty-two head and neck surgical patients with prolonged moderate to severe aspiration were assessed with videoendo-scopic and videofluoroscopic swallowing studies to reveal all components of dysphagia and aspiration. All patients received functional swallowing therapy, and 75% of the patients regained full oral intake diet. The duration of non-oral feeding varied widely. The outcome of swallowing rehabilitation (success or failure; duration of non-oral feeding) was statistically correlated with preoperative tumour stage, patients' age, therapy onset, severity of aspiration and the results of the videofluoroscopic measurements of oral and pharyngeal transit time, pharyngeal delay time, duration of laryngeal closure and cricopharyngeal opening, hyoid and laryngeal elevation, presence or absence of a stenosis at the pharyn-goesophageal segment. The following factors proved to be statistically significant for the prognostic estimate of swallowing rehabilitation: preoperative tumour stage, therapy onset, and severity of aspiration. For postoperative swallow recovery, an early therapy onset after thorough diagnostics with videoendoscopic and videofluoroscopic swallowing studies is recommended. Videofluoroscopic measurements will yield some prognostic estimate of oropharyngeal dysphagia and aspiration. Videoendoscopy, by it's availability and immediacy, proved to be useful for monitoring the course of rehabilitation.