Physiological changes to the swallowing mechanism following (Chemo)radiotherapy for head and neck cancer: a systematic review

Wall, Laurelie R., Ward, Elizabeth C., Cartmill, Bena and Hill, Anne J. (2013) Physiological changes to the swallowing mechanism following (Chemo)radiotherapy for head and neck cancer: a systematic review. Dysphagia, 28 4: 481-493. doi:10.1007/s00455-013-9491-8

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Author Wall, Laurelie R.
Ward, Elizabeth C.
Cartmill, Bena
Hill, Anne J.
Title Physiological changes to the swallowing mechanism following (Chemo)radiotherapy for head and neck cancer: a systematic review
Journal name Dysphagia   Check publisher's open access policy
ISSN 0179-051X
1432-0460
Publication date 2013-12-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s00455-013-9491-8
Open Access Status File (Author Post-print)
Volume 28
Issue 4
Start page 481
End page 493
Total pages 13
Place of publication New York, NY, United States
Publisher Springer
Language eng
Abstract Emerging research suggests that preventative swallowing rehabilitation, undertaken before or during (chemo)radiotherapy ([C]RT), can significantly improve early swallowing outcomes for head and neck cancer (HNC) patients. However, these treatment protocols are highly variable. Determining specific physiological swallowing parameters that are most likely to be impacted post-(C)RT would assist in refining clear targets for preventative rehabilitation. Therefore, this systematic review (1) examined the frequency and prevalence of physiological swallowing deficits observed post-(C)RT for HNC, and (2) determined the patterns of prevalence of these key physiological deficits over time post-treatment. Online databases were searched for relevant papers published between January 1998 and March 2013. A total of 153 papers were identified and appraised for methodological quality and suitability based on exclusionary criteria. Ultimately, 19 publications met the study’s inclusion criteria. Collation of reported prevalence of physiological swallowing deficits revealed reduced laryngeal excursion, base-of-tongue (BOT) dysfunction, reduced pharyngeal contraction, and impaired epiglottic movement as most frequently reported. BOT dysfunction and impaired epiglottic movement showed a collective prevalence of over 75 % in the majority of patient cohorts, whilst reduced laryngeal elevation and pharyngeal contraction had a prevalence of over 50 %. Subanalysis suggested a trend that the prevalence of these key deficits is dynamic although persistent over time. These findings can be used by clinicians to inform preventative intervention and support the use of specific, evidence-based therapy tasks explicitly selected to target the highly prevalent deficits post-(C)RT for HNC.
Keyword Deglutition
Deglutition disorders
Head and neck neoplasms
Swallow pathophysiology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
 
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