Pretreatment swallowing function in patients with head and neck cancer

• Published in: Head & neck Vol. 22; no. 5; pp. 474 - 482
• Main Authors: Pauloski, Barbara Roa, Rademaker, Alfred W., Logemann, Jerilyn A., Stein, David, Beery, Quinter, Newman, Lisa, Hanchett, Cathy, Tusant, Stephanie, MacCracken, Ellen
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.08.2000; John Wiley & Sons
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Chi-Square Distribution; Deglutition - physiology; Deglutition Disorders - physiopathology; dysphagia; Ent. Stomatology; Female; Fluoroscopy; Head and Neck Neoplasms - physiopathology; Humans; Investigative techniques, diagnostic techniques (general aspects); laryngeal; Laryngeal Neoplasms - physiopathology; Male; Medical sciences; Middle Aged; Mouth - physiopathology; Mouth Neoplasms - physiopathology; Neoplasm Staging; oral; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; pharyngeal; Pharyngeal Muscles - physiopathology; Pharyngeal Neoplasms - physiopathology; Pharynx - physiopathology; pretreatment; Radionuclide investigations; Time Factors; Tumors; Videotape Recording; Human; Videofluoroscopy; Radiodiagnosis; Esophageal disease; Stage classification; Exploration; Malignant tumor; Swallowing; Video recording; Head and neck; Digestive diseases; ENT disease; Adult; Complication; Medical imagery; Oral cavity disease; Pharynx disease; Dysphagia; Larynx disease; Pretreatment; Barium meal
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/1097-0347(200008)22:5<474::AID-HED6>3.0.CO;2-I

Background Few objective data characterizing the pretreatment swallow function of patients with head and neck cancer are available. Methods Pretreatment swallowing function in 352 patients with various lesions was evaluated with videofluoroscopy and compared with control subjects. Results Patients had significantly longer oral and pharyngeal transit times, greater amounts of oral and pharyngeal residue, shorter cricopharyngeal opening durations, and lower swallow efficiencies. Swallow function worsened significantly with increased tumor stage, and patients with oral or pharyngeal lesions had worse swallow function than patients with laryngeal lesions. Frequency of complaint of swallow difficulty before treatment was 59%. Patients with lower stage tumors had fewer complaints of swallowing, as did patients with oral cavity lesions. Conclusions Despite demonstrating significant differences from control subjects, patients had highly functional swallows before treatment. The tendency for patients not to perceive a swallowing problem is consistent with the highly functional nature of their pretreatment swallow. © 2000 John Wiley & Sons, Inc. Head Neck 22: 474–482, 2000.