Skip to main content
SpringerLink
Log in

A Systematic Review of Swallowing Training Measures for Postoperative Oral Cancer Patients

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Swallowing disorder is one of the most common postoperative complications for oral cancer patients and seriously influences quality of life. Limited attention has been paid to evaluating swallowing training measures in postoperative oral cancer patients. This study systematically reviewed swallowing training measures for these patients. A comprehensive search strategy was undertaken across various databases for studies published between database inception and 15 June 2021. Raters independently judged titles, abstracts and full articles for selection according to inclusion and exclusion criteria. The included literature was evaluated for quality and data were extracted. Meta-analyses were conducted using RevMan 5.3. Ten intervention studies (four randomized controlled trials and six quasi-experimental studies) involving 588 patients were identified. Across the studies, most started in the early postoperative stage; however, there were differences in starting time, training time and duration, and type of training. We summarized four training methods: oral exercise, oral sensory stimulation, compensatory strategies and protective airway manoeuvres. The meta-analysis indicated that swallowing training could improve patients’ swallowing function and quality of life in the short term, but the long-term effects were not obvious. Swallowing training mostly occurred in the early postoperative period and training measures were often used in combination. The timing, frequency and content of interventions varied between studies, and the effectiveness of any single measure was unclear. High-quality randomized controlled trials are necessary to study the efficacy and clinical applicability of various training measures, to provide a theoretical basis for their optimal selection and to develop a standardized training programme for postoperative oral cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.

    Article  PubMed  Google Scholar 

  2. Machiels JP, Rene Leemans C, Golusinski W, et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(11):1462–75. https://doi.org/10.1016/j.annonc.2020.07.011.

    Article  PubMed  Google Scholar 

  3. Koyfman SA, Ismaila N, Crook D, et al. Management of the neck in squamous cell carcinoma of the oral cavity and oropharynx: ASCO Clinical Practice Guideline. J Clin Oncol. 2019;37(20):1753–74. https://doi.org/10.1200/JCO.18.01921.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dou ZL. Evaluation and treatment of dysphagia. 2nd ed. Beijing: People’s Medical Publishing House; 2001.

    Google Scholar 

  5. Borggreven PA, Verdonck-de Leeuw I, Rinkel RN, et al. Swallowing after major surgery of the oral cavity or oropharynx: a prospective and longitudinal assessment of patients treated by microvascular soft tissue reconstruction. Head Neck. 2007;29(7):638–47. https://doi.org/10.1002/hed.20582.

    Article  PubMed  Google Scholar 

  6. Kreeft AM, van der Molen L, Hilgers FJ, et al. Speech and swallowing after surgical treatment of advanced oral and oropharyngeal carcinoma: a systematic review of the literature. Eur Arch Otorhinolaryngol. 2009;266(11):1687–98. https://doi.org/10.1007/s00405-009-1089-2.

    Article  PubMed  Google Scholar 

  7. Klingelhoffer C, Obst A, Ettl T, et al. Severe postoperative dysphagia as an early predictor for decreased overall survival in patients with oral cancer. J Craniomaxillofac Surg. 2019;47(9):1363–9. https://doi.org/10.1016/j.jcms.2019.06.011.

    Article  PubMed  Google Scholar 

  8. Bao X, Liu F, Lin J, et al. Nutritional assessment and prognosis of oral cancer patients: a large-scale prospective study. BMC Cancer. 2020;20(1):146. https://doi.org/10.1186/s12885-020-6604-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Rodriguez AM, Komar A, Ringash J, et al. A scoping review of rehabilitation interventions for survivors of head and neck cancer. Disabil Rehabil. 2019;41(17):2093–107. https://doi.org/10.1080/09638288.2018.1459880.

    Article  PubMed  Google Scholar 

  10. Sun YX, Jia XL, Liao SF, et al. Effect of swallowing rehabilitation on swallowing function and quality of life for head and neck cancer pa-tients: a meta-analysis. Chin J Rehabil Theory Pract. 2019;25(7):751–60. https://doi.org/10.3969/j.issn.1006?9771.2019.07.002.

    Article  Google Scholar 

  11. Umemoto G, Furuya H. Management of dysphagia in patients with parkinson’s disease and related disorders. Intern Med. 2020;59(1):7–14. https://doi.org/10.2169/internalmedicine.2373-18.

    Article  PubMed  Google Scholar 

  12. Kaneoka A, Yang S, Inokuchi H, et al. Presentation of oropharyngeal dysphagia and rehabilitative intervention following esophagectomy: a systematic review. Dis Esophagus. 2018;31(8):doy050. https://doi.org/10.1093/dote/doy050.

    Article  PubMed Central  Google Scholar 

  13. Flynn E, Smith CH, Walsh CD, et al. Modifying the consistency of food and fluids for swallowing difficulties in dementia. Cochrane Database Syst Rev. 2018;9:CD011077. https://doi.org/10.1002/14651858.CD011077.pub2.

    Article  PubMed  Google Scholar 

  14. Bath PM, Lee HS, Everton LF. Swallowing therapy for dysphagia in acute and subacute stroke. Cochrane Database Syst Rev. 2018;10:CD000323. https://doi.org/10.1002/14651858.CD000323.pub3.

    Article  PubMed  Google Scholar 

  15. Panebianco M, Marchese-Ragona R, Masiero S, et al. Dysphagia in neurological diseases: a literature review. Neurol Sci. 2020;41(11):3067–73. https://doi.org/10.1007/s10072-020-04495-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Zenga J, Goldsmith T, Bunting G, et al. State of the art: rehabilitation of speech and swallowing after total laryngectomy. Oral Oncol. 2018;86:38–47. https://doi.org/10.1016/j.oraloncology.2018.08.023.

    Article  PubMed  Google Scholar 

  17. Greco E, Simic T, Ringash J, et al. Dysphagia treatment for patients with head and neck cancer undergoing radiation therapy: a meta-analysis review. Int J Radiat Oncol Biol Phys. 2018;101(2):421–44. https://doi.org/10.1016/j.ijrobp.2018.01.097.

    Article  PubMed  Google Scholar 

  18. Hasegawa T, Yatagai N, Furukawa T, et al. The prospective evaluation and risk factors of dysphagia after surgery in patients with oral cancer. J Otolaryngol Head Neck Surg. 2021;50(1):4. https://doi.org/10.1186/s40463-020-00479-6.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Baijens LWJ, Walshe M, Aaltonen LM, et al. European white paper: oropharyngeal dysphagia in head and neck cancer. Eur Arch Otorhinolaryngol. 2021;278(2):577–616. https://doi.org/10.1007/s00405-020-06507-5.

    Article  PubMed  Google Scholar 

  20. Gu HQ, Wang Y, Li W. Application of the cochrane bias risk assessment tool in meta analysis of randomised controlled trials. Chin Circul J. 2014;29(2):147–8. https://doi.org/10.3969/j.issn.1000-3614.2014.02.017.

    Article  Google Scholar 

  21. Zhou YF, Gu Y, Hu Y, et al. Quality assessment tool of different types of research for JBI evideuce based health care: quality evaluation of intervention study. J Nurs Train. 2018;33(2):112–3. https://doi.org/10.16821/j.cnki.hsjx.2018.02.006.

    Article  Google Scholar 

  22. Hsiang CC, Chen AW, Chen CH, et al. Early postoperative oral exercise improves swallowing function among patients with oral cavity cancer: a randomized controlled trial. Ear Nose Throat J. 2019;98(6):E73-e80. https://doi.org/10.1177/0145561319839822.

    Article  PubMed  Google Scholar 

  23. Sezgin B, Durusoy D, Sezis Demirci M, et al. The effect of “xantan gum based fluid thickener” on hydration swallowing functions and nutritional status in total maxillectomy patients. Eur Arch Otorhinolaryngol. 2018;275(12):2997–3005. https://doi.org/10.1007/s00405-018-5167-1.

    Article  PubMed  Google Scholar 

  24. Zhang L, Huang Z, Wu H, et al. Effect of swallowing training on dysphagia and depression in postoperative tongue cancer patients. Eur J Oncol Nurs. 2014;18(6):626–9. https://doi.org/10.1016/j.ejon.2014.06.003.

    Article  PubMed  Google Scholar 

  25. Zhen Y, Wang JG, Tao D, et al. Efficacy survey of swallowing function and quality of life in response to therapeutic intervention following rehabilitation treatment in dysphagic tongue cancer patients. Eur J Oncol Nurs. 2012;16(1):54–8. https://doi.org/10.1016/j.ejon.2011.03.002.

    Article  PubMed  Google Scholar 

  26. Cheng Z, Tao JF, Jiang QL, et al. Effect of swallowing training on swallowing function and quality of life in patients with dysphagia after tongue cancer operation. Lingnan Mod Clin Surg. 2019;19(04):472–5. https://doi.org/10.3969/j.issn.1009-976X.2019.04.022.

    Article  Google Scholar 

  27. Huang ZS, Zhang DM, Wang YY, et al. Effect of early swallowing treatment on dysphagia and quality of life in tongue cancer patients after surgery. China J Oral Maxillofac Surg. 2017;15(03):249–53. https://doi.org/10.19438/j.cjoms.2017.03.012.

    Article  Google Scholar 

  28. Jiang TH, Wang Y, Zhuang H, et al. Application of swallowing training in enhanced recovery after surgery of oral cancer. China J Oral Maxillofac Surg. 2018;16(06):498–504. https://doi.org/10.19438/j.cjoms.2018.06.004.

    Article  Google Scholar 

  29. Liu HG, Jiang GC, Li JJ. Effects of diet detail nursing on swallowing function and quality of life in patients with mild-to-moderate dysphasia after oral cancer surgery. Chin J Mod Nurs. 2019;4(31):4088–93. https://doi.org/10.3760/cma.j.issn.1674-2907.2019.31.019.

    Article  Google Scholar 

  30. Shi ZY, Lv B, Shao J, et al. Effect of early rehabilitation training on language function, swallowing function and quality of life in patients with tongue cancer after free flap repair. Chongqing Med. 2019;48(07):1124–7. https://doi.org/10.3969/j.issn.1671-8348.2019.07.011.

    Article  Google Scholar 

  31. Shi YW, Yv W, Wang YQ, et al. Early intervention of oral exercise training program in patients after tongue reconstruction. J Qilu Nurs. 2019;25(04):65–7. https://doi.org/10.3969/j.issn.1006-7256.2019.04.023.

    Article  Google Scholar 

  32. Kaatzke-McDonald MN, Post E, Davis PJ. The effects of cold, touch, and chemical stimulation of the anterior faucial pillar on human swallowing. Dysphagia. 1996;11(3):198–206. https://doi.org/10.1007/BF00366386.

    Article  CAS  PubMed  Google Scholar 

  33. Teismann IK, Steinsträter O, Warnecke T, et al. Tactile thermal oral stimulation increases the cortical representation of swallowing. BMC Neurosci. 2009;10(1):71. https://doi.org/10.1186/1471-2202-10-71.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ebihara T, Ebihara S, Maruyama M, et al. A randomized trial of olfactory stimulation using black pepper oil in older people with swallowing dysfunction. J Am Geriatr Soc. 2006;54(9):1401–6. https://doi.org/10.1111/j.1532-5415.2006.00840.x.

    Article  PubMed  Google Scholar 

  35. Wang L, Deng HP, Cao J. Influence of rehabilitation therapy based on deep pharyngeal neuromuscular stimulation on dysphagia after stroke. Med Recapitulate. 2017;23(24):4988–92. https://doi.org/10.3969/j.issn.1006-2084.2017.24.038.

    Article  Google Scholar 

  36. Taniguchi H, Tsukada T, Ootaki S, et al. Correspondence between food consistency and suprahyoid muscle activity, tongue pressure, and bolus transit times during the oropharyngeal phase of swallowing. J Appl Physiol (1985). 2008;105(3):791–9. https://doi.org/10.1152/japplphysiol.90485.2008.

    Article  Google Scholar 

  37. Solazzo A, Monaco L, Del Vecchio L, et al. Investigation of compensatory postures with videofluoromanometry in dysphagia patients. World J Gastroenterol. 2012;18(23):2973–8. https://doi.org/10.3748/wjg.v18.i23.2973.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hoffman MR, Mielens JD, Ciucci MR, et al. High-resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver. Dysphagia. 2012;27(3):418–26. https://doi.org/10.1007/s00455-011-9385-6.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Bodén K, Hallgren A, Witt Hedström H. Effects of three different swallow maneuvers analyzed by videomanometry. Acta Radiol. 2006;47(7):628–33. https://doi.org/10.1080/02841850600774043.

    Article  PubMed  Google Scholar 

  40. Molfenter SM, Hsu CY, Lu Y, et al. Alterations to swallowing physiology as the result of effortful swallowing in healthy seniors. Dysphagia. 2018;33(3):380–8. https://doi.org/10.1007/s00455-017-9863-6.

    Article  PubMed  Google Scholar 

  41. Kim D, Li R. Contemporary treatment of locally advanced oral cancer. Curr Treat Options Oncol. 2019;20(4):32. https://doi.org/10.1007/s11864-019-0631-8.

    Article  PubMed  Google Scholar 

  42. Kaindlstorfer A, Pointner R. An appraisal of current dysphagia diagnosis and treatment strategies. Expert Rev Gastroenterol Hepatol. 2016;10(8):929–42. https://doi.org/10.1586/17474124.2016.1158098.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, 100081, China

    Jing Zhang, Hong-Yun Wu & Yue Yang

  2. Tianjin Medical University Eye Hospital, Tianjin, 300384, China

    Quan Li

Authors
  1. Jing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Quan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hong-Yun Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yue Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yue Yang.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, J., Li, Q., Wu, HY. et al. A Systematic Review of Swallowing Training Measures for Postoperative Oral Cancer Patients. Dysphagia 37, 1839–1850 (2022). https://doi.org/10.1007/s00455-022-10445-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-022-10445-1

Keywords

Search

Navigation