Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 3, Issue 5 | Research Article | Open Access DOI
Hardingham NM*
Hardingham NM1,2*, Ward EC2,3, Clayton NA2,4,5, Gallagher RM5,6,7
1Speech Pathology Department, St Vincent’s Hospital, Sydney NSW Australia
2School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia QLD Australia
3Centre for Functioning and Health Research, Metro South Health, Queensland Health, Buranda QLD Australia
4Speech Pathology Department, Concord Repatriation General Hospital, Sydney NSW Australia
5Faculty of Medicine and Health, University of Sydney, NSW Australia 6Otolaryngology, St Vincent’s Hospital, Sydney, NSW Australia 7University of New South Wales, Kensington, Australia
*Correspondence to: Hardingham NM
Fulltext PDFAims: Dysphagia is a common consequence of oral/oropharyngeal squamous cell carcinoma (OC/OPSCC) and its treatments. Preliminary evidence indicates that severe dysphagia may follow OC/OPSCC resection via the mandibular lingual release approach (MLRA), but further research is required. This prospective case series documents dysphagia presentation and outcomes up to 12-months post-treatment for OC/OPSCC involving the MLRA.Material and Methods: Five consecutive patients with advanced OC/OPSCC (T3, N+) were planned for multi- modal treatment, including surgery via MLRA. Data was collected at five endpoints: baseline (pre-treatment), acute and 6-weeks post-operative, then 6 and 12-months post-treatment. Clinical and fluoroscopic swallowing assessments included the functional oral intake scale (FOIS), penetration-aspiration scale (PAS); dynamic imaging grade of swallowing toxicity (DIGEST), MBS impairment profile (MBSImp) and MD Anderson dysphagia inventory (MDADI).Results: Pre-surgery mild-moderate impairment in swallowing efficiency was observed (FOIS moderate=3, mild=2). In the acute post-operative stage, all cases showed severely impaired swallowing efficiency and safety (FOIS severe=5; DIGEST life-threatening=4). Minimal improvements were observed at six-weeks (n=4), with persistent static impairments in swallowing efficiency and safety at six-months (FOIS severe=4; DIGEST moderate=4). At 12-months, the surviving cases (n=3), remained gastrostomy dependent (FOIS severe=3; DIGEST severe=1, moderate=2). MBSImp revealed significant deficits in oral and pharyngeal swallowing, while MDADI scores indicated severe early impacts followed by ongoing moderate effectors on swallowing-related quality of life.
Conclusion: Dysphagia is a severe and persistent complication of OC/OPSCC treated with a MLRA, significantly impacting quality of life. Comprehensive dysphagia management is essential from diagnosis through to survivorship for these patients.
Dysphagia; Mandibular lingual release approach; Head and neck cancer; Speech-language pathology
Hardingham NM, Ward EC, Clayton NA, Gallagher RM. Dysphagia Recovery Following Surgical Resection of Oral and Oropharyngeal Cancer via the Mandibular Lingual Release Approach. Annal of Otol Head and Neck Surg. 2024;3(5):1-15.