Michelle Florie1, Walmari Pilz1,2, Bernd Kremer1,2, Femke Verhees1, Ghislaine Waltman1, Bjorn Winkens3, Naomi Winter1, Laura Baijens1,2. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. 2. GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center Maastricht, Maastricht, The Netherlands. 3. CAPHRI - Care and Public Health Research Institute, Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands.
Abstract
OBJECTIVE: The purpose of this study was to determine the relationship between patient-reported symptoms of oropharyngeal dysphagia (OD) using the Eating Assessment Tool (EAT)-10 and the swallowing function using a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol in head and neck cancer (HNC) patients with confirmed OD. METHODS: Fifty-seven dysphagic HNC patients completed the EAT-10 and a FEES. Two blinded clinicians scored the randomized FEES examinations. Exclusion criteria consisted of presenting with a concurrent neurological disease, scoring below 23 on a Mini-Mental State Examination, being older than 85 years, having undergone a total laryngectomy, and being illiterate or blind. Descriptive statistics, linear regression, sensitivity, specificity, and predictive values were calculated. RESULTS: The majority of the dysphagic patients (N = 38; 66.7%) aspirated after swallowing thin liquid consistency. A large number of patients showed postswallow pharyngeal residue while swallowing thick liquid consistency. More specifically, 42 (73.0%) patients presented postswallow vallecular residue, and 39 (67.9%) patients presented postswallow pyriform sinus residue. All dysphagic patients had an EAT-10 score ≥ 3. Linear regression analyses showed significant differences in mean EAT-10 scores between the dichotomized categories (abnormal vs. normal) of postswallow vallecular (P = .037) and pyriform sinus residue (P = .013). No statistically significant difference in mean EAT-10 scores between the dichotomized categories of penetration or aspiration was found (P = .966). CONCLUSION: The EAT-10 questionnaire seems to have an indicative value for the presence of postswallow pharyngeal residue in dysphagic HNC patients, and a value of 19 points turned out to be useful as a cutoff point for the presence of pharyngeal residue in this study population. LEVEL OF EVIDENCE: 2B.
OBJECTIVE: The purpose of this study was to determine the relationship between patient-reported symptoms of oropharyngeal dysphagia (OD) using the Eating Assessment Tool (EAT)-10 and the swallowing function using a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol in head and neck cancer (HNC) patients with confirmed OD. METHODS: Fifty-seven dysphagic HNCpatients completed the EAT-10 and a FEES. Two blinded clinicians scored the randomized FEES examinations. Exclusion criteria consisted of presenting with a concurrent neurological disease, scoring below 23 on a Mini-Mental State Examination, being older than 85 years, having undergone a total laryngectomy, and being illiterate or blind. Descriptive statistics, linear regression, sensitivity, specificity, and predictive values were calculated. RESULTS: The majority of the dysphagic patients (N = 38; 66.7%) aspirated after swallowing thin liquid consistency. A large number of patients showed postswallow pharyngeal residue while swallowing thick liquid consistency. More specifically, 42 (73.0%) patients presented postswallow vallecular residue, and 39 (67.9%) patients presented postswallow pyriform sinus residue. All dysphagic patients had an EAT-10 score ≥ 3. Linear regression analyses showed significant differences in mean EAT-10 scores between the dichotomized categories (abnormal vs. normal) of postswallow vallecular (P = .037) and pyriform sinus residue (P = .013). No statistically significant difference in mean EAT-10 scores between the dichotomized categories of penetration or aspiration was found (P = .966). CONCLUSION: The EAT-10 questionnaire seems to have an indicative value for the presence of postswallow pharyngeal residue in dysphagic HNCpatients, and a value of 19 points turned out to be useful as a cutoff point for the presence of pharyngeal residue in this study population. LEVEL OF EVIDENCE: 2B.
Authors: César Álvarez-Marcos; Andrea Vicente Benito; Agueda Gayol Fernández; Daniel Pedregal-Mallo; Paloma Sirgo Rodríguez; Liliana Santamarina Rabanal; José Luis Llorente; Fernando López; Juan Pablo Rodrigo Journal: Eur Arch Otorhinolaryngol Date: 2021-05-07 Impact factor: 2.503