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Oral Cancer pp 373-401 | Cite as

Management of Dysphagia Following Treatment for Oral Cancer

  • Koji TakahashiEmail author
Chapter

Abstract

This chapter is focusing on the management of dysphagia caused by the treatment of oral cancer. The causes, site-specific characteristics, evaluation, and treatment of dysphagia following oral cancer treatment are introduced in detail. The noninstrumental evaluating methods, the cervical auscultation, the videofluoroscopic swallow study, the videoendoscopic swallow study, and the ultrasound study are introduced in the section of the evaluation methods for dysphagia. The treatment methods for dysphagia include the airway clearance techniques, the compensatory techniques, and the swallow exercises. The short-term intensive dysphagia rehabilitation is also introduced. The sophisticated techniques and newly developed methods in both evaluation and treatment for dysphagia are introduced with a lot of clinical figures. Chapter  16 and this chapter provide the clinicians the way how to manage the oral and pharyngeal dysfunction caused after the treatment of oral cancer.

Keywords

Cervical auscultation Evaluation of dysphagia Management of dysphagia Site specific characteristics Treatment of dysphagia 

References

  1. 1.
    Pauloski BR, Logemann JA, Rademaker AW et al (1994) Speech and swallowing function after oral and oropharyngeal resections: one-year follow-up. Head Neck 16(4):313–322CrossRefPubMedGoogle Scholar
  2. 2.
    McConnel FMS, McConnel FM, Logemann JA, Rademaker AW et al (1994) Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: a pilot study. Laryngoscope 104(1):87–90CrossRefPubMedGoogle Scholar
  3. 3.
    Bonanno PC (1971) Swallowing dysfunction after tracheotomy. Ann Surg 174:29–33CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Cameron JL, Renolds J, Zuidema GD et al (1973) Aspiration in patients with tracheostomies. Surg Gynecol Obstetr 136:68–70Google Scholar
  5. 5.
    Bone DK, Davis JL, Zuidema GD, Cameron JL et al (1974) Aspiration pneumonia: prevention of aspiration in patients with tracheostomies. Ann Thoracic Surg 18:30–37CrossRefGoogle Scholar
  6. 6.
    Nash M (1988) Swallowing problems in the tracheostomized patient. Otolaryngol Clin North Am 21(4):701–709PubMedGoogle Scholar
  7. 7.
    Muz J, Sandra H, Robert M, Ronnie F et al (1994) Scintigraphic assessment of aspiration in head and neck cancer patients with tracheostomy. Head Neck 16:17–20CrossRefPubMedGoogle Scholar
  8. 8.
    Buchbinder D, Currivan RB, Kaplan AJ, Urken ML et al (1993) Mobilization regimens for the prevention of jaw hypomobility in the radiated patient: a comparison of three techniques. J Oral Maxillofac Surg 51:863–867CrossRefPubMedGoogle Scholar
  9. 9.
    Pauloski BR, Rademaker AW, Logemann JA, Colangelo LA (1998) Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients. Otolaryngol Head Neck Surg 118(5):616–624PubMedGoogle Scholar
  10. 10.
    Logemann JA, Smith CH, Pauloski BR, Rademaker AW, Lazarus CL et al (2001) Effects of xerostomia on perception and performance of swallow function. Head Neck 23(4):317–321CrossRefPubMedGoogle Scholar
  11. 11.
    Hamlet S, Faull J, Klein B, Aref A et al (1997) Mastication and swallowing in patients with postirradiation xerostomia. Int J Radiat Oncol Biol Phys 37(4):789–796CrossRefPubMedGoogle Scholar
  12. 12.
    Pauloski BR, Logemann JA, Joan CF, Colangelo LA et al (1995) Biomechanical analysis of the pharyngeal swallow in postsurgical patients with anterior tongue and floor of mouth resection and distal flap reconstruction. J Speech Hear Res 38:110–123CrossRefPubMedGoogle Scholar
  13. 13.
    Ekberg O, Göran N et al (1983) Pharyngeal dysfunction after treatment for pharyngeal cancer with surgery and radiotherapy. Gastrointest Radiol 8:97–104CrossRefPubMedGoogle Scholar
  14. 14.
    Logemann JA, Pauloski BR, Rademaker AW, McConnel FMS (1993) Speech and swallow function after tonsil/base of tongue resection with primary closure. J Speech Hear Res 36:918–926CrossRefPubMedGoogle Scholar
  15. 15.
    Nishiwaki K, Tsuji T, Liu M, Hase K, Tanaka N, Fujiwara T (2005) Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables. J Rehabil Med 37(4):247–251CrossRefPubMedGoogle Scholar
  16. 16.
    Okamoto N, Tomioka K, Saeki K, Iwamoto J et al (2012) Relationship between swallowing problems and tooth loss in community-dwelling independent elderly adults. J Am Geriatr Soc 60(5):849–853CrossRefPubMedGoogle Scholar
  17. 17.
    Osawa A, Maeshima S, Tanahashi N (2013) Water-swallowing test: screening for aspiration in stroke patients. Cerebrovasc Dis 35(3):276–281CrossRefPubMedGoogle Scholar
  18. 18.
    Wakasugi Y, Tohara H, Hattori F, Motohashi Y et al (2008) Screening test for silent aspiration at the bedside. Dysphagia 23(4):364–370CrossRefPubMedGoogle Scholar
  19. 19.
    Saito E (2000) An integrated research on treatment and handling of dysphagia: general research report. In: Research project on aging and health, fiscal 1999 health and labour sciences research grant (Chief researcher: Saito E) (in Japanese) 3 ml food, Apr 2000, pp 1–18Google Scholar
  20. 20.
    Shinjo Y, Okitsu A, Ukeda I, Miyagi A, Domen K et al (2013) Effects of posture on subjective swallowing difficulty during screening tests for dysphagia. Int J Phys Med Rehabil 1(4):133Google Scholar
  21. 21.
    Oguchi K, Saitoh E, Baba M, Kusudo S et al (2000) The repetitive saliva swallowing test (RSST) as a screening test of functional dysphagia (2nd report)-validity of RSST (in Japanese). Jpn J Rehabil Med 37(6):383–388CrossRefGoogle Scholar
  22. 22.
    Hongama S, Nagao K, Toko S et al (2012) MI sensor-aided screening system for assessing swallowing dysfunction: application to the repetitive saliva swallowing test. J Prosthodont Res 56(1):53–57CrossRefPubMedGoogle Scholar
  23. 23.
    Takahashi K (1998) Cervical auscultation. In: Kaneko Y (ed) Eating and swallowing rehabilitation. Ishiyaku Publishers, Tokyo, pp 171–175 (in Japanese)Google Scholar
  24. 24.
    Takahashi K, Uyama R, Hirano K, Yamashita Y et al (2001) Accuracy of cervical auscultation for detecting dysphagia in head and neck cancer patients (in Japanese). Head Neck Cancer 27(1):198–203CrossRefGoogle Scholar
  25. 25.
    Logemann JA, Pauloski BR, Rademaker AW, McConnel FM, Heiser MA, Cardinale S et al (1997) Speech and swallowing rehabilitation in head and neck cancer patients. Oncology 11:651–659PubMedGoogle Scholar
  26. 26.
    Takahashi K (1998) Treatment strategies. In: Kaneko Y et al (eds) Dysphagia rehabilitation. Ishiyaku Publishing, Tokyo, pp 175–183 (in Japanese)Google Scholar
  27. 27.
    Takahashi K, Uyama R et al (1999) Swallow exercises in patients with head and neck cancer: objective assessment of swallow functions and subjective assessment by patients. Jpn J Head Neck Cancer 25(1):123–129CrossRefGoogle Scholar
  28. 28.
    Takahashi K, Michi K (1999) Rehabilitation of dysphagia. In: Enomoto S et al (eds) Latest oral surgery (in Japanese), 4th edn. Ishiyaku Publishing, Tokyo, pp 422–426Google Scholar
  29. 29.
    Takahashi K (2000) Rehabilitation of dysphagia in patients with head and neck cancer (video). Tokyo, Ishiyaku Pub, in JapaneseGoogle Scholar
  30. 30.
    Takahashi K (2003) Dysphagia rehabilitation: management of dysphagia in patients with head and neck cancer. In: Uematsu H et al (eds) Dental guidebook for the elderly. Ishiyaku Publishing, Tokyo, pp 265–273 (in Japanese)Google Scholar
  31. 31.
    Namba A, Yamashita Y, Takahashi K et al (2001) Application of a systematic manual for training swallowing disorders to postoperative oral cancer patients. J Jpn Stomatol Soc 50(2):122–129Google Scholar
  32. 32.
    Logemann JA, Ashford JR, McCullough G et al (1994) Effects of postural change on aspiration in head and neck surgical patients. Otolaryngol Head Neck Surg 110:222–227PubMedGoogle Scholar
  33. 33.
    Welch MV, Logemann JA, Rademaker AW, Kahrilas PJ et al (1993) Changes in pharyngeal dimensions effected by chin tuck. Arch Phys Med Rehabil 74:178–181PubMedGoogle Scholar
  34. 34.
    Shanahan TK, Logemann JA, Rademaker AW, Pauloski BR, Kahrilas PJ et al (1993) Chin-down posture effect on aspiration in dysphagic patients. Arch Phys Med Rehabil 74:736–739CrossRefPubMedGoogle Scholar
  35. 35.
    Fukasawa M, Takahashi K et al (2004) Effects of postural adjustment techniques on dysphagia in head and neck surgical patients: videofluoroscopic comparison of the upright posture and the posture with head tilted to the stronger side. Jpn J Oral Maxillofac Surg 50(8):461–465, in JapaneseCrossRefGoogle Scholar
  36. 36.
    Fukasawa M, Takahashi K et al (2006) Effects of postural adjustment techniques on dysphagia in patients with tongue cancer: comparison of successful and unsuccessful cases with the head tilt posture. Jpn J Oral Maxillofac Surg 52:225–233, in JapaneseCrossRefGoogle Scholar
  37. 37.
    Felt P et al (2002) National dysphagia task force. In: The national dysphagia diet: standardization for optimal care. American Dietetic Association, ChicagoGoogle Scholar
  38. 38.
    Wheeler R, Logemann JA, Rosen MS et al (1980) Maxillary reshaping prosthesis: effectiveness in improving speech and swallowing of post-surgical oral cancer patients. J Prosthet Dent 43:313–319CrossRefPubMedGoogle Scholar
  39. 39.
    Davis J, Lazarus C, Logemann JA, Hurst PS et al (1987) Effect of maxillary glossectomy prosthesis on articulation and swallowing. J Prosthet Dent 57:715–719CrossRefPubMedGoogle Scholar
  40. 40.
    Pauloski B et al (1996) Effect of intraoral prostheses on swallowing function in postsurgical oral and oropharyngeal cancer patients. Am J Speech Lang Pathol 5:31–46CrossRefGoogle Scholar
  41. 41.
    Takahashi K (2006) Function recovering devices for disorders: devices for dysphagia. In: Mayazaki T et al (eds) Clinical dental engineering. Ishiyaku Publishing, Tokyo, pp 302–307 (in Japanese)Google Scholar
  42. 42.
    Michael A Crary (2010) Changing the swallow: active therapy techniques. Chapter 14 Treatment for Adults. pp285-296 Michael E. Groher and Michael A. Crary Dysphagia: Clinical Management in Adults and Children. 2010 Mosby ElsevierGoogle Scholar
  43. 43.
    Lazarus CL (1993) Effect of radiation therapy and voluntary maneuvers on swallow functioning in head and neck cancer patients. Clin Commun Disord 3(4):11–20PubMedGoogle Scholar
  44. 44.
    Lazarus CL, Logemann JA, Gibbons P (1993) Effect of maneuvers on swallowing function in a dysphagic oral cancer patient. Head Neck 15:419–424CrossRefPubMedGoogle Scholar
  45. 45.
    Dou Z, Zu Y, Wen H, Wan G et al (2012) The effect of different catheter balloon dilatation modes on cricopharyngeal dysfunction in patients with dysphagia. Dysphagia 27(4):514–520CrossRefPubMedGoogle Scholar
  46. 46.
    Shaker R, Easterling C, Kern M, Nitschke T et al (2002) Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology 122(5):1314–1321CrossRefPubMedGoogle Scholar
  47. 47.
    Crary MA, Groher ME (2000) Basic concepts of surface electromyographic biofeedback in the treatment of dysphagia. Am J Speech Lang Pathol 9:116–125CrossRefGoogle Scholar
  48. 48.
    Beom J, Kim SJ, Han TR (2011) Electrical stimulation of the suprahyoid muscles in brain-injured patients with dysphagia: a pilot study. Ann Rehabil Med 35(3):322–327CrossRefPubMedCentralPubMedGoogle Scholar
  49. 49.
    Kim SR, Kwon KH, Cho BJ (2013) The effects of neuromuscular electrical stimulation on pharyngeal transit time. J Phys Ther Sci 25(7):849–851CrossRefPubMedCentralPubMedGoogle Scholar
  50. 50.
    Takahashi K (2009) Management of dysphagia in post-surgical head and neck cancer patients with intractable dysphagia-hospitalization for dysphagic patients who were told in other clinics that in would be impossible or extremely difficult to eat orally. J Jpn Soc Oral Tumors 21(4):245–254CrossRefGoogle Scholar
  51. 51.
    Takahashi K, Uyama R, Yokoyama K, Nakamichi Y et al (2011) Management of dysphagia for patients being treated for head and neck cancer in our department. Head Neck Cancer 37(4):508–513Google Scholar
  52. 52.
    Yuasa K, Yokoyama K, Takei Y, Nakamichi Y et al (2013) Effectiveness of short-term intensive dysphagia rehabilitation in head and neck cancer patients with severe dysphagia. Dysphagia 28:647Google Scholar

Copyright information

© Springer Japan 2015

Authors and Affiliations

  1. 1.Division of Oral Rehabilitation Medicine, Department of Special Needs Oral medicineSchool of Dentistry, Showa UniversityTokyoJapan

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