Multidimensional Rehabilitation in Patients with Aspiration Following Head and Neck Cancer Treatment

두경부암 치료에 따라 발생한 흡인 환자에 대한 다각적 재활운동 치료

  • Jung, Young Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Jin, Young Ju (Department of Otorhinolaryngology-Head and Neck Surgery, Wonkwang University Hospital, Wonkwang University College of Medicine)
  • 정영호 (서울대학교 의과대학 분당서울대학교병원 이비인후-두경부외과학교실) ;
  • 진영주 (원광대학교 의과대학 원광대학교병원 이비인후-두경부외과학교실)
  • Received : 2016.11.25
  • Accepted : 2017.03.01
  • Published : 2018.06.30

Abstract

Patients who have the head and neck cancer are usually treated by surgery, radiation therapy, chemotherapy, or combinations of them. These treatments can induce variable degree of aspiration with dysphagia. The type and severity of aspiration depends on the size and location of the original tumor, the structures involved, and the treatment modality used for treatment. The management of aspiration after the head and neck cancer's treatment begins with an accurate evaluation for the cause and mechanism of aspiration through modified barium swallow (MBS) and fiberoptic endoscopic examination of swallowing (FEES). Then, the clinician can use postures, maneuvers, and exercises to treat the swallow disorder and to help the patient achieve optimal function. To achieve optimal swallowing without aspiration, multidimensional rehabilitation by various medical personnel is definitely necessary.

Keywords

References

  1. Pulte D, Brenner H. Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis. Oncologist 2010;15(9):994-1001. https://doi.org/10.1634/theoncologist.2009-0289
  2. Smith RV, Kotz T, Beitler JJ, Wadler S. Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea: initial results. Archives of Otolaryngology-Head & Neck Surgery 2000;126(3):384-9. https://doi.org/10.1001/archotol.126.3.384
  3. Kreuzer SH, Schima W, Schober E, Pokieser P, Kofler G, Lechner G, et al. Complications after laryngeal surgery: videofluoroscopic evaluation of 120 patients. Clinical Radiology 2000;55(10):775-81. https://doi.org/10.1053/crad.2000.0517
  4. Pauloski BR, Rademaker AW, Logemann JA, McConnel F, Heiser MA, Cardinale S, et al. Surgical variables affecting swallowing in patients treated for oral/oropharyngeal cancer. Head & Neck 2004; 26(7):625-36. https://doi.org/10.1002/hed.20013
  5. Hara I, Gellrich N-C, Duker J, Schon R, Nilius M, Fakler O, et al. Evaluation of swallowing function after intraoral soft tissue reconstruction with microvascular free flaps. International Journal of Oral and Maxillofacial Surgery 2003;32(6):593-9. https://doi.org/10.1054/ijom.2002.0436
  6. Pauloski BR. Rehabilitation of dysphagia following head and neck cancer. Physical Medicine and Rehabilitation Clinics of North America 2008;19(4):889-928. https://doi.org/10.1016/j.pmr.2008.05.010
  7. Pauloski BR, Rademaker AW, Logemann JA, Discekici-Harris M, Mittal BB. Comparison of swallowing function after intensitymodulated radiation therapy and conventional radiotherapy for head and neck cancer. Head & Neck 2015;37(11):1575-82. https://doi.org/10.1002/hed.23796
  8. Ohmae Y, Karaho T, Hanyu Y, Murase Y, Kitahara S, Inouye T. [Effect of posture strategies on preventing aspiration]. Nihon Jibiinkoka Gakkai Kaiho 1997;100(2):220-6. https://doi.org/10.3950/jibiinkoka.100.220
  9. Rasley A, Logemann J, Kahrilas P, Rademaker A, Pauloski B, Dodds W. Prevention of barium aspiration during videofluoroscopic swallowing studies: value of change in posture. AJR. American Journal of Roentgenology 1993;160(5):1005-9. https://doi.org/10.2214/ajr.160.5.8470567
  10. Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ. Effects of postural change on aspiration in head and neck surgical patients. Otolaryngology--Head and Neck Surgery 1994;110(2):222-7. https://doi.org/10.1177/019459989411000212
  11. Zuydam A, Rogers S, Brown J, Vaughan E, Magennis P. Swallowing rehabilitation after oro-pharyngeal resection for squamous cell carcinoma. British Journal of Oral and Maxillofacial Surgery 2000;38(5):513-8. https://doi.org/10.1054/bjom.2000.0482
  12. Lewin JS, Hebert TM, Putnam JB, DuBrow RA. Experience with the chin tuck maneuver in postesophagectomy aspirators. Dysphagia 2001;16(3):216-9. https://doi.org/10.1007/s00455-001-0068-6
  13. Logemann J, Kahrilas P, Kobara M, Vakil N. The benefit of head rotation on pharyngoesophageal dysphagia. Archives of Physical Medicine and Rehabilitation 1989;70(10):767-71.
  14. Kagaya H, Inamoto Y, Okada S, Saitoh E. Body positions and functional training to reduce aspiration in patients with dysphagia. JMAJ 2011;54(1):35-8.
  15. Easterling C. Shaker exercise. Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition: Springer;2013. p.257-68.
  16. Martin BJ, Logemann JA, Shaker R, Dodds WJ. Normal laryngeal valving patterns during three breath-hold maneuvers: a pilot investigation. Dysphagia 1993;8(1):11-20. https://doi.org/10.1007/BF01351472
  17. Lazarus C, Logemann JA, Song CW, Rademaker AW, Kahrilas PJ. Effects of voluntary maneuvers on tongue base function for swallowing. Folia Phoniatrica et Logopaedica 2002;54(4):171-6. https://doi.org/10.1159/000063192
  18. Ryu JS, Kang JY, Park JY, Nam SY, Choi SH, Roh JL, et al. The effect of electrical stimulation therapy on dysphagia following treatment for head and neck cancer. Oral Oncology 2009;45(8):665-8. https://doi.org/10.1016/j.oraloncology.2008.10.005
  19. Langmore SE, McCulloch TM, Krisciunas GP, Lazarus CL, Van Daele DJ, Pauloski BR, et al. Efficacy of electrical stimulation and exercise for dysphagia in patients with head and neck cancer: A randomized clinical trial. Head Neck 2016;38 Suppl 1:E1221-31. https://doi.org/10.1002/hed.24197
  20. van der Molen L, van Rossum MA, Burkhead LM, Smeele LE, Rasch CR, Hilgers FJ. A randomized preventive rehabilitation trial in advanced head and neck cancer patients treated with chemoradiotherapy: feasibility, compliance, and short-term effects. Dysphagia 2011;26(2):155-70. https://doi.org/10.1007/s00455-010-9288-y
  21. 21Eades M, Murphy J, Carney S, Amdouni S, Lemoignan J, Jelowicki M, et al. Effect of an interdisciplinary rehabilitation program on quality of life in patients with head and neck cancer: review of clinical experience. Head & Neck 2013;35(3):343-9. https://doi.org/10.1002/hed.22972