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Results of pretreatment swallowing evaluation in patients with stage III/IV laryngeal and hypopharyngeal carcinoma

  • Head and Neck
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Abstract

Introduction

Laryngeal and hypopharyngeal carcinoma are among the common head and neck cancers causing considerable swallowing dysfunction. The functional status of the organ (larynx) is an important point of contention while considering the patients for organ preservation protocol.

Methodology

The aim of this retrospective study was to assess the swallowing status in stage III/IV laryngeal and hypopharyngeal carcinoma and its influence on treatment decision. We evaluated all treatment naïve patients who were referred to the swallowing clinic in 2017 (Jan–Dec) for assessment of swallowing prior to treatment initiation.

Results

One hundred patients satisfied the eligibility criteria and were included in the study. The site and stage of laryngeal and hypopharyngeal cancer cases were almost equal in number. Their median age was 58 years. Fiberoptic endoscopic evaluation of swallowing (FEES) was done in all patients. 30% of the patients only had swallowing difficulties. Only advanced T-stage (p = 0.04) had an influence on the pretreatment swallowing status. Thirty-seven patients required nasogastric tube (NGT) for feeding. By 2 month post-treatment completion, most patients on NGT could resume oral feeding.

Conclusions

Pretreatment swallowing assessment alone did not significantly seem to influence our decisions for organ preservation treatment. However, patients with aspiration could be identified and managed appropriately. Most patients on NGT could resume oral feeds post-treatment completion.

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Authors and Affiliations

  1. Division of Speech & Swallowing Pathology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India

    Arun Balaji

  2. Department of Head & Neck Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, 400012, India

    Shivakumar Thiagarajan, Nandini Menon, Adhara Chakraborthy & Devendra Chaukar

  3. Department of ENT, Chairing Cross Hospital, London, UK

    Akshat Mallik

Authors
  1. Arun Balaji
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  2. Shivakumar Thiagarajan
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  3. Akshat Mallik
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  4. Nandini Menon
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  5. Adhara Chakraborthy
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  6. Devendra Chaukar
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Contributions

Study concepts: ST, DC, and AB. Study design: ST and AM. Data acquisition: AM, NM, and AC. Quality control of data and algorithms: ST. Statistical analysis: ST. Manuscript preparation: AB, ST, AM, NM, AC, and DC. Manuscript editing: ST and DC. Manuscript reviewing: AB, ST, AM, NM, AC, and DC.

Corresponding author

Correspondence to Shivakumar Thiagarajan.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

Institute ethical committee clearance taken for this study (Project Number-3308). All received the standard of care for their condition and was as per the ethical standards.

Informed consent

No identifying information about participants is available in the article. However, all patients have given consent for the treatment they have received.

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Balaji, A., Thiagarajan, S., Mallik, A. et al. Results of pretreatment swallowing evaluation in patients with stage III/IV laryngeal and hypopharyngeal carcinoma. Eur Arch Otorhinolaryngol 278, 3011–3018 (2021). https://doi.org/10.1007/s00405-020-06460-3

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  • DOI: https://doi.org/10.1007/s00405-020-06460-3

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