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Oral Cavity Cancers: Management of Dysphagia in Partial Glossectomy
Oral Kavite Kanserleri: Parsiyel Glossektomide Disfaji Yönetimi
Received Date : 17 May 2023
Accepted Date : 21 Aug 2023
Available Online : 04 Sep 2023
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Fatma Cemre SAZAK KUNDİa, Çağla ELİKÜÇÜKa, Fatma ESEN AYDINLIb
aAnkara Bilkent Şehir Hastanesi, Kulak Burun Boğaz Hastalıkları Kliniği, Ankara, Türkiye bHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Dil ve Konuşma Terapisi Bölümü, Ankara, Türkiye
Doi: 10.24179/kbbbbc.2023-98022 - Makale Dili: TR
Kulak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi. 2023;31(4):223-30.
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
In this study, the effect of dysphagia management in a partial glossectomy case was investigated. The patient is given the flexible endoscopic evaluation of swallowing and videofluoroscopic swallowing study/Modified Barium Swallow Study from the instrumental swallowing assessment. Penetration Aspiration Scala (PAS) and The Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) were used. Functional Oral Intake Scale (FOIS) score was determined. Oral hygiene, expiratory muscle training, tongue-strengthening exercises, phonation studies, secretion swallowing with supraglottic swallowing technique, “chin tuck”, Effortful swallow, Mendelsohn maneuver, “slurp-swallow-sweeping” swallowing, maintaining mouth opening (Temporomandibular joint) were studied. Eating assesment tool (EAT- 10) and European Organization for the Research and Treatment of Cancer, Quality of Life Assessments in Head and Neck Cancer (EORTC QLQ-H&N35) were used. While the PAS before the therapy was PAS: 7, it was PAS: 2 after the therapy. While the FOIS score before the therapy is 1, it was 7 after the therapy (EAT-10 score: 33 to 3). While the YPRSRS score was 3.8 before the therapy, it was 0.8 after the therapy. EORTC QLQ-H&N35 score decreased after the therapy. In partial glossectomy cases, swallowing therapy has a positive effect on achieving optimal swallowing physiology.
Keywords: Partial glossectomy; dysphagia; swallowing therapy; fiberoptic endoscopic swallowing study; quality of life in head and neck cancer patients
ÖZET
Parsiyel glossektomi vakasında, disfaji yönetiminin etkisi incelenmiştir. Hastaya klinik yutma değerlendirmesi ve yatak başı yutma değerlendirmesinin yanında enstrümental yutma değerlendirme araçları olan fiberoptik endoskopik yutma değerlendirmesi ve videofloroskopik yutma çalışması/modifiye baryum yutma çalışması da yapılmıştır. Penetrasyon-Aspirasyon Skalası (PAS) ve Yale Rezidü Şiddeti Belirleme Skalası (YRŞBS) kullanılmıştır. Fonksiyonel Oral Alım Skalası [Functional Oral Intake Scale (FOİS)] skoru belirlenmiştir. Oral hijyen, ekspratuar kas eğitimi, dirençli dil kökü egzersizi, fonasyon çalışmaları, supraglottik yutma tekniği ile sekresyon yutma, “chin tuck”, eforlu yutma, Mendelsohn manevrası, “slurp-swallow-süpürerek” yutma öğretilmesi, ağız açıklığının korunması (temporamandibular eklem-çalıştırma) egzersizleri çalışılmıştır. Yemek yeme aracı [Eating Assesment Tool (EAT-10)] ve Baş Boyun Kanseri hastaları Yaşam Kalitesi Ölçeği (EORTC QLQ-H&N35) kullanılmıştır. Terapi öncesi PAS: 7 iken, terapi sonrası PAS: 2 olmuştur. Terapi öncesi FOİS skoru 1 iken, terapi sonrası FOİS skoru 7’dir (EAT-10 skoru 33’den 3’e azalmıştır). YRŞBS skoru terapi öncesi 3,8 iken, terapi sonrası 0,8’tir. Terapi sonrasında EORTC QLQ-H&N35 skoru azalmıştır. Parsiyel glossektomi vakalarında, hastanın optimal yutma fizyolojisine kavuşmasında yutma terapisinin olumlu etkisi vardır.
Anahtar Kelimeler: Parsiyel glossektomi; disfaji; yutma terapisi; fiberoptik endoskobik yutma çalışması; baş-boyun kanseri hastaları yaşam kalitesi
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