Preoperative predictors of dysphagia after transoral surgery

Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the...

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Bibliographic Details
Published in:International journal of clinical oncology 2021-05, Vol.26 (5), p.835-840
Main Authors: Fujiwara, Kazunori, Taira, Kenkichiro, Donishi, Ryohei, Koyama, Satoshi, Morisaki, Tsuyoshi, Fukuhara, Takahiro, Takeuchi, Hiromi
Format: Article
Language:English
Subjects:
Body mass index
Cancer Research
Dysphagia
Head & neck cancer
Medicine
Medicine & Public Health
Oncology
Original
Original Article
Pharynx
Quality of life
Radiation therapy
Surgery
Surgical Oncology
Swallowing
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Summary:Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the preoperative predictive factors for postoperative dysphagia in patients undergoing TOS. Methods One hundred and twenty patients who underwent TOS were evaluated in this study. The degree of dysphagia was evaluated using the Functional Outcome Swallowing Scale (FOSS) both preoperatively and 3 months postoperatively. Those whose FOSS stage was maintained postoperatively were classified into the FOSS-M group, while those with increased FOSS stage postopratively were classified into the FOSS-I group. The following parameters were assessed before surgery: age, weight, height, body mass index (BMI), forced expiratory volume in 1 s, and history of head and neck radiotherapy. Videofluoroscopy (VF) was performed preoperatively to evaluate swallowing function using the Penetration-Aspiration Scale (PAS). Results The BMI of the FOSS-M group was significantly higher than that of the FOSS-I group. A history of radiotherapy was significantly more common in the FOSS-I group than in the FOSS-M group. Finally, preoperative PAS in the FOSS-M group was lower than that in the FOSS-I group. Conclusion This study suggested that patients with preoperative aspiration detected using VF might develop postoperative dysphagia severely. In addition, preoperative low BMI and a history of previous radiotherapy for head and neck cancer were associated with postoperative dysphagia. Objective examinations such as VF should be performed preoperatively.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-021-01860-9