Longitudinal Evaluation of Swallowing with Videofluoroscopy in Patients with Locally Advanced Head and Neck Cancer After Chemoradiation

AbstractThe aim of this study was to investigate the prevalence, severity, and pattern of evolution of swallowing impairments encountered in head and neck cancer (HNC) patients before and after chemoradiation (CRT) with videofluoroscopy of swallowing study (VFSS), using the modified barium swallow impairment profile (MBSImP) protocol and scoring system, and to determine the appropriate time points in which these patients should undergo VFSS post-CRT. A prospective cohort of 69 patients with locally advanced HNC underwent VFSS with the MBSImP protocol at 5 evaluation points: pre-CRT, and 1, 3, 6, and 12  months post-CRT. VFSS was scored with MBSImP, penetration–aspiration scale (PAS), and swallowing performance status (SPS) scale. Statistical analysis was performed only for the 12-month disease-free subset of patients. MBSImP, PAS, and SPS scale scores reached their peak at 3 months post-CRT an d improved at 6–12 months, but without returning at pre-treatment levels. Base of tongue retraction, initiation of pharyngeal swallow, epiglottic movement, laryngeal vestibule closure, and laryngeal elevation were the most frequently observed impaired MBSImP components. Epiglottic movement signif icantly improved (p = 0.009) and laryngeal vestibule closure significantly deteriorated (p = 0.042) over time (Friedman test). Severe swallowing deficits and high aspiration rates are observed in HNC patients pre-CRT, which further deterior...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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Publication date: March 2018Source: Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 29, Issue 1Author(s): Daniel Kwon, Alfred SimentalStandard operative techniques for thyroidectomy have become well refined and widely disseminated. However, special circumstances, such as superior pole thyroid cancers, can present unique difficulties for the unprepared surgeon. Appropriate workup and appreciation of the unique anatomical relationships in the superior-most extent of the thyroid gland is vital in surgical planning. The ability to anticipate and manage a variety of contingencies such as superior laryngeal ...
Source: Operative Techniques in Otolaryngology Head and Neck Surgery - Category: ENT & OMF Source Type: research
We present the case of a 70-year-old tracheostomy-dependent patient with pharyngolaryngeal stenosis and a history of radiation therapy for laryngeal cancer in remission for 13 years and multiple decannulation failures. Endoscopic pharyngolaryngoplasty was performed using reconstructive transoral laser microsurgery techniques, allowing permanent decannulation. Endoscopic sutures secured by clips were performed to remodel the pharyngolarynx and prevent recurrence of synechiae.DiscussionEndoscopic surgery of the pharynx and larynx was initially developed for resection of small tumours. Reconstructive transoral laser micr...
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases - Category: ENT & OMF Source Type: research
ConclusionThe translation and adaptation into Brazilian Portuguese of the Radiotherapy Edema Rating Scale was successfully performed and showed to be easy to apply.ResumoIntroduçãoO linfedema interno é uma das sequelas do tratamento para o câncer de cabeça e pescoço, podendo levar a alterações de grau variado na deglutição, voz e respiração. A Escala do Edema da Radioterapia (Radiotherapy Edema Rating Scale), elaborada por Patterson et al., é uma ferramenta de avaliação do edema de faringe e laringe.ObjetivoTraduzir, par...
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
Publication date: March 2018Source: Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 29, Issue 1Author(s): Daniel Kwon, Alfred SimentalStandard operative techniques for thyroidectomy have become well refined and widely disseminated. However, special circumstances, such as superior pole thyroid cancers, can present unique difficulties for the unprepared surgeon. Appropriate workup and appreciation of the unique anatomical relationships in the superior-most extent of the thyroid gland is vital in surgical planning. The ability to anticipate and manage a variety of contingencies such as superior laryngeal ...
Source: Operative Techniques in Otolaryngology Head and Neck Surgery - Category: ENT & OMF Source Type: research
We present the case of a 70-year-old tracheostomy-dependent patient with pharyngolaryngeal stenosis and a history of radiation therapy for laryngeal cancer in remission for 13 years and multiple decannulation failures. Endoscopic pharyngolaryngoplasty was performed using reconstructive transoral laser microsurgery techniques, allowing permanent decannulation. Endoscopic sutures secured by clips were performed to remodel the pharyngolarynx and prevent recurrence of synechiae.DiscussionEndoscopic surgery of the pharynx and larynx was initially developed for resection of small tumours. Reconstructive transoral laser micr...
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases - Category: ENT & OMF Source Type: research
CONCLUSIONS: Polymorphic variant XRCC1 HNSCC patients treated with CCRT have significantly increased acute radiation morbidities and may have a trend toward better PFS in comparison with the wild variant. PMID: 29893275 [PubMed - in process]
Source: Health Physics - Category: Physics Authors: Tags: Int J Radiat Oncol Biol Phys Source Type: research
Conclusions Major and minor salivary and seromucous glands consistently have high PSMA-ligand uptake. Minor gland locations can be selectively visualized by this technique for the first time. This provides potential new applications such as quantification of present salivary gland tissues and individualization of radiotherapy for head and neck cancer or lutetium-177-PSMA radionuclide treatment.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
Authors: Colevas AD, Yom SS, Pfister DG, Spencer S, Adelstein D, Adkins D, Brizel DM, Burtness B, Busse PM, Caudell JJ, Cmelak AJ, Eisele DW, Fenton M, Foote RL, Gilbert J, Gillison ML, Haddad RI, Hicks WL, Hitchcock YJ, Jimeno A, Leizman D, Maghami E, Mell LK, Mittal BB, Pinto HA, Ridge JA, Rocco J, Rodriguez CP, Shah JP, Weber RS, Witek M, Worden F, Zhen W, Burns JL, Darlow SD Abstract The NCCN Guidelines for Head and Neck (H&N) Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided for o...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
AbstractThere have been few published studies on differences between Blacks and Whites in the estimated effects of alcohol and tobacco use on the incidence of head and neck cancer (HNC) in the United States. Previous studies have been limited by small numbers of Blacks. Using pooled data from 13 US case –control studies of oral, pharyngeal, and laryngeal cancers in the International Head and Neck Cancer Epidemiology Consortium, this study comprised a large number of Black HNC cases (n = 975). Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for several...
Source: Cancer Causes and Control - Category: Cancer & Oncology Source Type: research
AbstractTo evaluate timing and duration differences in airway protection and esophageal opening after oral intubation and mechanical ventilation for acute respiratory distress syndrome (ARDS) survivors versus age-matched healthy volunteers. Orally intubated adult ( ≥ 18 years old) patients receiving mechanical ventilation for ARDS were evaluated for swallowing impairments via a videofluoroscopic swallow study (VFSS) during usual care. Exclusion criteria were tracheostomy, neurological impairment, and head and neck cancer. Previously recruited healthy volu nteers (n = 56) served as age-matched c...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research
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