Impact of tongue base mucosectomy on quality-of-life outcomes: systematic review and single-centre experience.

Autor: Scholfield DW; Department of Otolaryngology Head and Neck Surgery, Imperial College Healthcare, NHS Trust, London, W6 8RF, UK., Williamson AJ; Department of Otolaryngology Head and Neck Surgery, Imperial College Healthcare, NHS Trust, London, W6 8RF, UK., Cunning N; Department of Otolaryngology Head and Neck Surgery, Imperial College Healthcare, NHS Trust, London, W6 8RF, UK., Awad Z; Department of Otolaryngology Head and Neck Surgery, Imperial College Healthcare, NHS Trust, London, W6 8RF, UK. zawad@nhs.net.; Department of Surgery and Cancer, Imperial College London, London, UK. zawad@nhs.net.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Oct 04. Date of Electronic Publication: 2024 Oct 04.
DOI: 10.1007/s00405-024-08976-4
Abstrakt: Purpose: Tongue base mucosectomy (TBM) is a well-established procedure in investigating cervical squamous cell carcinoma of occult primary. However, its risks have not been balanced against its benefits with validated tools.
Methods: A systematic literature review was conducted for reported complications and quality-of-life outcomes following TBM. The complications and quality-of-life outcomes following TBM at our institution are then reported using objective metrics and validated assessment tools, including Performance Status Scale for Head and Neck Cancer Patients (PSS-HNS), University of Washington Quality-of-life Questionnaire (UW-QOL) and M. D. Anderson Dysphagia Inventory (MDADI).
Results: Eighteen studies met the criteria for inclusion in the systematic review. Of these, 9 addressed swallowing outcomes described in text, without using validated assessment tools. No studies reported taste, speech and pain outcomes after TBM. Post-operative bleeding was not consistently reported. 20 patients underwent robotic TBM at our institution between 2017 and 2023. The primary tumour was identified in 50% (10/20) of cases. The median time to commencing soft diet and median time of NG feeding was 0 days. The median return to normalcy of diet score was 95. Median post-treatment UW-QOL pain and swallowing scores were 100 and 70 respectively. The median speech score was 100, saliva 70, and taste 70. The median normalised MDADI scores were: global 80; emotional 67; functional 80 and physical 65.
Conclusions: Validated assessment tools better inform patients about treatment options and can help compare post-TBM results across institutions. Our data demonstrates that TBM patients have a functional post-operative swallow, are pain and gastrostomy free, even after adjuvant treatment. Routine post-operative insertion of NG tube is not necessary.
(© 2024. Crown.)
Databáze: MEDLINE
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