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Interdisciplinary Telemedicine in the Management of Dysphagia in Head and Neck

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Abstract

The study considered the feasibility and impact of interdisciplinary telemedicine discussions in the management of post-treatment dysphagia in patients with head and neck tumors. This is a retrospective analysis of patients with persistent dysphagia after treatment for head and neck pathology, at an institute in India. The cases were discussed in the telemedicine meeting conducted between host institute and a second unit in the United States. A monthly meeting was organized, using an internet-based video conference system. The ongoing swallowing problems and management were presented, and through discussions, a plan for further management was formulated and carried out. The Functional Oral Intake Scale (FOIS) was measured before and after the implementation of the plan. Twenty-six patients were discussed, out of which, 22 were head and neck malignancies. The recommendations concurred with that of the host unit in 18, differed for three and additive in five patients. The pre-treatment mean FOIS was 1.46 with a standard deviation of 0.989 and post-treatment mean improved to 3.92 with a standard deviation of 1.809 (p < 0.0001). The present study supports the success of an interdisciplinary telemedicine meeting to manage difficult cases of dysphagia in head and neck. The outcome in terms of the FOIS score improved significantly after implementing them. In addition to the direct patient benefits, the meeting helped to facilitate interdepartmental collaboration between two units treating similar sets of patients across the globe, in specialized clinical areas like dysphagia management.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, AIMS Ponekkara PO, Kochi, Kerala, India

    Mydhili Mayadevi, Krishnakumar Thankappan, Shashikant Vishnubhai Limbachiya, Sivakumar Vidhyadharan, Deepak Balasubramanian, Jayakumar R. Menon & Subramania Iyer

  2. USC Caruso Department of Otolaryngology-Head and Neck Surgery, Keck Medicine of USC, University of Southern California, Los Angeles, USA

    Brenda Villegas, Melody Ouyoung & Uttam Sinha

Authors
  1. Mydhili Mayadevi
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  2. Krishnakumar Thankappan
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  3. Shashikant Vishnubhai Limbachiya
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  4. Sivakumar Vidhyadharan
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  5. Brenda Villegas
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  6. Melody Ouyoung
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  7. Deepak Balasubramanian
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  8. Jayakumar R. Menon
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  9. Uttam Sinha
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  10. Subramania Iyer
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Corresponding author

Correspondence to Krishnakumar Thankappan.

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Mayadevi, M., Thankappan, K., Limbachiya, S.V. et al. Interdisciplinary Telemedicine in the Management of Dysphagia in Head and Neck. Dysphagia 33, 474–480 (2018). https://doi.org/10.1007/s00455-018-9876-9

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  • DOI: https://doi.org/10.1007/s00455-018-9876-9

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