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Introduction The use of minimal invasive surgical techniques have gained considerable ground over the past decade. With the improvement of robotic surgical technologies, we have seen a sharp rise in the amount of centers offering transoral robotic surgery (TORS). While this treatment is still relatively new, there are studies describing good outcomes in the treatment of head and neck neoplasms.TORS is also used for the treatment of benign conditions such as sleep apnea and benign conditions in the pharynx. One of the main benefits og using a minimal invasive technique such as TORS is that there is an expected better quality of life (QoL) after TORS treatment compared to that of traditional treatment, for example radiotherapy. A key component of QoL is ones ability to swallow safely, efficiently, and without pain or discomfort. There have been studies performed, and other studies that are under way, that aim to investigate this further. There are, however, questions that remain unanswered. In fact there are questions have not even been asked yet? How should one go about testing for oropharyngeal dysphagia (OD)? What instrumental evaluations are useful for this patient group? There is, as yet, little consensus on a standardized protocol for, for example Fiberoptic Endoscopic Evaluation of Swallowing (FEES) or Videofluoroscopy (VFS). Should there be a protocol for these evaluations specifically designed for this patient group? Is there a role for High-Resolution Pharyngeal Manometry and Impedance (HRPMI) following TORS, considering the tissue loss after, for example a radical tonsillectomy or base of tongue resection may change pressure gradients in the pharynx compared with other dysphagia patient groups? Aim This scoping review aims to systematically identify, comprehensively summarize and critique studies reporting on the instrumental evaluation of OD in patients that have undergone TORS treatment for both benign and malignant disease. Search strategy and study selection A university librarian will be consulted in preparation of the search strategy.The following databases will be searched: PubMed, EMBASE, Web of Science, and grey litterature.The search string will be appropriately adapted for each of the selected databases. Studies in all languages will be included provided an adequate translation can be obtained. Titles and abstracts will be screened independently by two people. A customized inclusion/exclusion form will be used to screen abstracts. Full text versions of the chosen studies will be downloaded for further assessment of their eligibility for inclusion. Any disagreements will be resolved by consensus. Inclusion criteria: All types of studies including instrumental evaluation of swallowing function (FEES, VFS, HRPMI) in patients treated with TORS will be included. Exclusion criteria: Reviews. Data extraction and synthesis Each study will be assessed by two people and a custom database will be used to gather the data. The reporting of the collected data will follow the guideline provided in the PRISMA extension for scoping reviews. Dissemination The scoping review will be published in a peer-reviewed journal and presented at appropriate conferences. Conclusion This systematic review will present important information regarding the reporting of instrumental evaluation of OD in patients who have undergone TORS. It will analyse the quality of studies done in this area. Furthermore, it will form the basis for further investigations into the evaluation of OD in this patient group. |
