FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer,European Archives of Oto-Rhino-Laryngology

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FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer
European Archives of Oto-Rhino-Laryngology ( IF 1.9 ) Pub Date : 2023-02-14 , DOI: 10.1007/s00405-023-07865-6
Christiane Hey ₁ , Almut Goeze ₁ , Robert Sader ₂ , Eugen Zaretsky ₁

Affiliation

Purpose

Oropharyngeal dysphagia is one of the most common postoperative consequences in head and neck cancer patients. Above all, these patients often suffer from aspiration and limitations of oral intake. However, no reliable dysphagia screening is available for this target group. This study aimed to develop and validate a screening, FraMaDySc, based on a water swallow test (WST) for the identification of postsurgical patients with a risk of aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia in general (OD) that constituted the main reference standard.

Methods

A total of 184 postsurgical head and neck cancer patients were tested with a WST. The patients were, on average, 62 years old and predominantly male (71%). After WST, they underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES^®). FEES^® results were dichotomized by Penetration aspiration scale and Functional oral intake scale. Patients with a “fail” result on one of these two scales were classified as having OD. Quality criteria of WST were quantified by means of cross-tabulation with FEES^® results.

Results

OD was found in 65% of patients, aspiration in 44%, limitations of oral intake in 56%. WST delivered a “fail” result in 65% of patients. WST showed sensitivity 91% and specificity 88% for OD. Quality criteria for aspiration (sensitivity 64%, specificity 93%) and limitations of oral intake (sensitivity 80%, specificity 87%) were lower.

Conclusion

FraMaDySc is a standardized, quick, and valid WST and therefore an excellent screening tool for the identification of OD in postoperative head and neck cancer patients.

中文翻译：

FraMaDySc：头颈癌术后患者的吞咽困难筛查

目的

口咽部吞咽困难是头颈癌患者最常见的术后后果之一。最重要的是，这些患者经常遭受误吸和口服摄入量的限制。然而，没有针对该目标群体的可靠吞咽困难筛查。本研究旨在开发和验证基于水吞咽试验 (WST) 的筛查 FraMaDySc，用于识别具有误吸风险、口腔摄入受限以及作为其衍生物的一般相关口咽吞咽困难的术后患者(OD) 构成主要参考标准。

方法

共有 184 名术后头颈癌患者接受了 WST 测试。患者平均年龄为 62 岁，主要为男性 (71%)。在 WST 之后，他们接受了吞咽纤维内镜评估 (FEES® ⁾。FEES ^®结果按渗透吸入量表和功能性经口摄入量表进行二分法。在这两个量表之一上具有“失败”结果的患者被归类为患有 OD。WST 的质量标准通过与 FEES ^®结果交叉制表的方式进行量化。