Characterizing postoperative physiologic swallow function following transoral robotic surgery for early stage tonsil, base of tongue, and unknown primary human papillomavirus-associated squamous cell carcinoma.

Autor: Ottenstein L; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Cornett H; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Switchenko JM; Department of Biostatistics & Bioinformatics, Winship Cancer Institute, Atlanta, Georgia, USA., Nathan M; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Thomas S; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Gillespie AI; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., McColloch N; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Barrett T; Winship Cancer Institute, Atlanta, Georgia, USA., Studer MB; Emory University School of Medicine, Atlanta, Georgia, USA., Brinkman M; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA., Kaka AS; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.; Winship Cancer Institute, Atlanta, Georgia, USA., Boyce BJ; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.; Winship Cancer Institute, Atlanta, Georgia, USA., Ferris RL; Department of Otolaryngology - Head & Neck Surgery, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Aiken AH; Department of Radiology, Emory University School of Medicine, Atlanta, Georgia, USA., El-Deiry M; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.; Winship Cancer Institute, Atlanta, Georgia, USA., Beitler JJ; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.; Winship Cancer Institute, Atlanta, Georgia, USA.; Department of Radiation Oncology, Winship Cancer Institute, Atlanta, Georgia, USA., Patel MR; Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.; Winship Cancer Institute, Atlanta, Georgia, USA.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2021 May; Vol. 43 (5), pp. 1629-1640. Date of Electronic Publication: 2021 Feb 05.
DOI: 10.1002/hed.26632
Abstrakt: Background: Data objectively evaluating acute post-transoral robotic surgery (TORS) swallow function are limited. Our goal was to characterize and identify clinical variables that may impact swallow function components 3 weeks post-TORS.
Methods: Retrospective cohort study. Pre/postoperative use of the Modified Barium Swallow Impairment Profile (MBSImP) and Penetration-Aspiration Scale (PAS) was completed on 125 of 139 TORS patients (2016-2019) with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma. Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scores were retrospectively calculated. Uni/multivariate analysis was performed.
Results: Dysfunctional pre-TORS DIGEST scores were predictive of post-TORS dysphagia (p = 0.015). Pre-TORS MBSImP deficits in pharyngeal stripping wave, swallow initiation, and clearing pharyngeal residue correlated with airway invasion post-TORS based on PAS scores (p = 0.012, 0.027, 0.048, respectively). Multivariate analysis of DIGEST safety scores declined with older age (p = 0.044). Odds ratios (ORs) for objective swallow function components after TORS were better for unknown primary and tonsil primaries compared to base of tongue (BOT) (OR 0.35-0.91).
Conclusions: Preoperative impairments in specific MBSImP components, older patients, and BOT primaries may predict more extensive recovery in swallow function after TORS.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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