Prognostic factors for swallowing rehabilitation following head and neck cancer surgery
Prognostic factors for swallowing rehabilitation following head and neck cancer surgery
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DOI：
10.3109/00016489709113476
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发表时间：
1997-09-01
影响因子：
1.4
通讯作者：
Eibenberger, K
中科院分区：
文献类型：
--
作者：
Denk, DM;Swoboda, H;Eibenberger, K
32例头颈部手术患者长期中度至重度误吸进行了视频内窥镜和视频透视吞咽研究，以揭示吞咽困难和误吸的所有组成部分。所有患者均接受功能性吞咽治疗，75%的患者恢复了完全经口进食。非口服喂养的持续时间差异很大。吞咽康复的结果（成功或失败;非经口进食的持续时间）与术前肿瘤分期、患者年龄、治疗开始、误吸严重程度以及口腔和咽通过时间、咽延迟时间、喉闭合和颈咽打开的持续时间、舌骨和喉抬高的视频荧光镜测量结果在统计学上相关，咽食管段是否存在狭窄。以下因素被证明是统计学意义的吞咽康复的预后估计：术前肿瘤分期，治疗开始，严重程度的吸入。对于术后吞咽恢复，建议在通过视频内窥镜和视频荧光透视吞咽研究进行全面诊断后进行早期治疗。视频荧光镜测量将产生口咽吞咽困难和误吸的一些预后估计。电视内窥镜，它的可用性和即时性，被证明是有用的监测过程中的康复。
Thirty-two head and neck surgical patients with prolonged moderate to severe aspiration were assessed with videoendoscopic 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 pharyngoesophageal 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.