Efficacy of thickened liquids for eliminating aspiration in head and neck cancer: a systematic review.

OBJECTIVE: To appraise the current videofluoroscopic evidence on the reduction of aspiration using thickened liquids in the head and neck cancer population. DATA SOURCES: Search terms relating to deglutition or dysphagia or swallow and neoplasms and oncology or head and neck cancer and viscosity or texture and apira or residu* were combined with honey or nectar, xerostomia, and respiratory aspiration using Boolean operators. REVIEW
METHODS: A multiengine literature search identified 337 nonduplicate articles, of which 6 were judged to be relevant. These underwent detailed review for study quality and qualitative synthesis.
RESULTS: The articles reviewed in detail predominantly described heterogeneous study samples with small sample sizes, making for difficult interpretation and generalization of results. Rates of aspiration were typically not reported by bolus consistency, despite the fact that a variety of stimulus consistencies was used during a videofluoroscopic swallowing study. Studies confirmed that aspiration is a major concern in the head and neck cancer population and reported a trend toward more frequent aspiration after (chemo)radiotherapy.
CONCLUSION: Overall, the literature on thickened liquids as an intervention to eliminate aspiration in the head and neck cancer population is limited. Because aspiration is known to be prevalent in the head and neck cancer population and thickened liquids are known to eliminate aspiration in other populations, it is important to determine the effectiveness of thickened liquids for reducing aspiration in the head and neck cancer population. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.