Dysphagia in Tongue Cancer Patients
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objective To identify risk factors for dysphagia in tongue cancer patients. Dysphagia is a common complication of surgery, radiotherapy, and chemotherapy in tongue cancer patients. Previous studies have attempted to identify risk factors for dysphagia in patients with head and neck cancer, but no studies have focused specifically on tongue cancer patients. Methods This study was conducted on 133 patients who were diagnosed with tongue cancer and who underwent a videofluoroscopy swallowing study (VFSS) between January 2007 and June 2012 at the Asan Medical Center. Data collected from the VFSS were analyzed retrospectively. Patients with aspiration were identified. Results Patients showed a higher incidence of inadequate tongue control, inadequate chewing, delayed oral transit time, aspiration or penetration, vallecular pouch and pyriform residue, and inadequate laryngeal elevation after surgery. Moreover, male gender, extensive tumor resection, a higher node stage, and more extensive lymph node dissection were major risk factors for aspiration in tongue cancer patients. Conclusion Tongue cancer patients have difficulties in the pharyngeal phase as well as the oral phase of swallowing. These difficulties can worsen after tongue cancer surgery. Gender, the extent of tumor resection, and lymph node metastasis affect swallowing in tongue cancer patients. Physicians should take these risk factors into account when administering swallowing therapy to tongue cancer patients.
Abstract
Objective To identify risk factors for dysphagia in tongue cancer patients. Dysphagia is a common complication of surgery, radiotherapy, and chemotherapy in tongue cancer patients. Previous studies have attempted to identify risk factors for dysphagia in patients with head and neck cancer, but no studies have focused specifically on tongue cancer patients. Methods This study was conducted on 133 patients who were diagnosed with tongue cancer and who underwent a videofluoroscopy swallowing study (VFSS) between January 2007 and June 2012 at the Asan Medical Center. Data collected from the VFSS were analyzed retrospectively. Patients with aspiration were identified. Results Patients showed a higher incidence of inadequate tongue control, inadequate chewing, delayed oral transit time, aspiration or penetration, vallecular pouch and pyriform residue, and inadequate laryngeal elevation after surgery. Moreover, male gender, extensive tumor resection, a higher node stage, and more extensive lymph node dissection were major risk factors for aspiration in tongue cancer patients. Conclusion Tongue cancer patients have difficulties in the pharyngeal phase as well as the oral phase of swallowing. These difficulties can worsen after tongue cancer surgery. Gender, the extent of tumor resection, and lymph node metastasis affect swallowing in tongue cancer patients. Physicians should take these risk factors into account when administering swallowing therapy to tongue cancer patients.
참고문헌 (22)
- Nguyen NP, "Aspiration rate following chemoradiation for head and neck cancer: an underreported occurrence", Radiother Oncol, 80, pp.302~306 (2006)
- Nguyen NP, "Impact of swallowing therapy on aspiration rate following treatment for locally advanced head and neck cancer", Oral Oncol, 43, pp.352~357 (2007)
- Soo Jin Jung, "Rick Factors Associated with Aspiration in Patients with Head and Neck Cancer", Annals of Rehabilitation Medicine, 35(6), pp.781~790 (2011), 대한재활의학회
- Kotz T, "Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck", Head Neck, 26, pp.365~372 (2004)
- Namaki S, "Videofluorographic evaluation of dysphagia before and after modification of the flap and scar in patients with oral cancer", J Plast Surg Hand Surg, 45, pp.136~142 (2011)
- Logemann JA, "Speech and swallow function after tonsil", base of tongue resection with primary closure, 1993, pp.36, 918~926
- Pauloski BR, "Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction", J Speech Hear Res, 36, pp.267~276 (1993)
- Han TR, "The functional dysphagia scale using videofluoroscopic swallowing study in stroke patients", J Korean Acad Rehabil Med, 23, pp.1118~1126 (1999)
- Pannunzio TG., "Aspiration of oral feedings in patients with tracheostomies", AACN Clin Issues, 7, pp.560~569 (1996)
- Starmer H, "Pretreatment swallowing assessment in head and neck cancer patients", Laryngoscope, 121, pp.1208~1211 (2011)
- Molfenter SM, "The relationship between residue and aspiration on the subsequent swallow: an application of the normalized residue ratio scale", Dysphagia, 28, pp.494~500 (2013)
- Kikawada M, "Aspiration and infection in the elderly: epidemiology, diagnosis and management", Drugs Aging, 22, pp.115~130 (2005)
- Smith RV, "Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea: initial results", Arch Otolaryngol Head Neck Surg, 126, pp.384~389 (2000)
- Agarwal J, "Objective assessment of swallowing function after definitive concurrent (chemo)radiotherapy in patients with head and neck cancer", Dysphagia, 26, pp.399~406 (2011)
- Carrara-de Angelis E, "Voice and swallowing in patients enrolled in a larynx preservation trial", Arch OtolaryngolHead Neck Surg, 129, pp.733~738 (2003)
- Nguyen NP, "Dysphagia following chemoradiation for locally advanced head and neck cancer", Ann Oncol, 15, pp.383~388 (2004)
- Steiniger JR, "Morbidity of combined therapy for the treatment of supraglottic carcinoma: supraglottic laryngectomy and radiotherapy", Ann Otol Rhinol Laryngol, 106, pp.151~158 (1997)
- Plant RL., "Anatomy and physiology of swallowing in adults and geriatrics", Otolaryngol Clin North Am, 31, pp.477~488 (1998)
- Weber RS, "Functional results after total or near total glossectomy with laryngeal preservation", Arch Otolaryngol Head Neck Surg, 117, pp.512~515 (1991)
- Lango MN, "Impact of neck dissection on long-term feeding tube dependence in patients with head and neck cancer treated with primary radiation or chemoradiation", Head Neck, 32, pp.341~347 (2010)
- Wilkins T, "The prevalence of dysphagia in primary care patients: a HamesNet Research Network study", J Am Board Fam Med, 20, pp.144~150 (2007)
- Wall LR, "Physiological changes to the swallowing mechanism following (chemo)radiotherapy for head and neck cancer: a systematic review", Dysphagia, 28, pp.481~493 (2013)