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Relationship between swallowing-related quality of life and fiberoptic endoscopic evaluation of swallowing in patients who underwent open partial horizontal laryngectomy

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Abstract

Background

Several studies have previously analyzed the relationship between QOL and signs of dysphagia in patients treated for head and neck cancer and have reported heterogeneous findings. To the best of our knowledge, no study has previously investigated this relationship among patients who underwent open partial horizontal laryngectomy (OPHL). The aim of the study is to determine if patient-reported swallowing-related QOL can discriminate between safe and unsafe swallowing in OPHL patients.

Methods

92 type I, type II, and type III OPHL patients at least 6 months postoperatively were recruited. Fiberoptic endoscopic evaluation of swallowing (FEES) was conducted using liquids, semisolids, and solids. FEES recordings were assessed through the penetration–aspiration scale, the pooling score and the dysphagia outcome and severity scale. All patients completed the MD Anderson dysphagia inventory (MDADI). Kruskal–Wallis test and post-hoc Mann Whitney U test were performed to compare MDADI scores among different level of airway invasion, post-swallow pharyngeal residue’s degree and overall dysphagia severity. ROC curves were generated to determine diagnostic accuracy of the MDADI.

Results

Statistically significant differences in MDADI scores were found between level of airway invasion with semisolids and solids, degree of pharyngeal residue with solids, and severity of dysphagia. MDADI showed significant diagnostic accuracy only in the detection of moderate/severe pharyngeal residue and severe dysphagia; however, sensitivity and specificity were low.

Conclusions

Investigating patients’ perception of swallowing impairment and swallowing-related QOL is not sufficient to discriminate safe and unsafe swallowing in OPHL patients.

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Author information

Authors and Affiliations

  1. Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy

    Nicole Pizzorni & Antonio Schindler

  2. Head Neck Department - Oncology Department, FPO IRCCS Candiolo Cancer Institute, Turin, Italy

    Marco Fantini, Giovanni Succo & Erika Crosetti

  3. Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy

    Andy Bertolin & Giuseppe Rizzotto

  4. Department of Clinical Sciences and Community Health, Medical Statistics, Biometry and Bioinformatics, University of Milan, Milan, Italy

    Federico Ambrogi

  5. UOS Foniatria, Azienda Ospedaliera-Polo Universitario “L. Sacco”, Via GB Grassi 74, 20154, Milan, Italy

    Antonio Schindler

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  1. Nicole Pizzorni
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  2. Antonio Schindler
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Contributions

Nicole Pizzorni, Speech and Language Pathologist, functional analysis, conception and design, drafting the article, final approval of the version to be published; Antonio Schindler, phoniatrician who carried out the functional analysis, conception and design, drafting the article, final approval of the version to be published; Marco Fantini, data collection, conception and design, final approval of the version to be published; Andy Bertolin, surgeon who carried out the functional endoscopic study of swallowing, conception and design, final approval of the version to be published; Giuseppe Rizzotto, surgeon who performed surgical procedures, conception and design, final approval of the version to be published; Federico Ambrogi, statistical analysis, final approval of the version to be published; Giovanni Succo, surgeon who performed surgical procedures, conception and design, drafting the article, final approval of the version to be published; Erika Crosetti, surgeon who carried out the functional endoscopic study of swallowing, conception and design, final approval of the version to be published.

Corresponding author

Correspondence to Nicole Pizzorni.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Luigi Sacco Hospital research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Pizzorni, N., Schindler, A., Fantini, M. et al. Relationship between swallowing-related quality of life and fiberoptic endoscopic evaluation of swallowing in patients who underwent open partial horizontal laryngectomy. Eur Arch Otorhinolaryngol 275, 973–985 (2018). https://doi.org/10.1007/s00405-018-4888-5

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