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논문 기본 정보

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학술저널
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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제56권 제5호
발행연도
2015.1
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1,221 - 1,226 (6page)

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Purpose: The purposes of this study were to evaluate specific dysphagia patterns and to identify the factors affecting dysphagia, especially aspiration, following treatment of head and neck cancer. Materials and Methods: A retrospective analysis of 57 patients was performed. Dysphagia was evaluated using a modified bariumswallow (MBS) test. The MBS results were rated on the 8-point penetration-aspiration scale (PAS) and swallowing performancestatus (SPS) score. Results: Reduced base of the tongue (BOT) retraction (64.9%), reduced laryngeal elevation (57.9%), and cricopharyngeus (CP) dysfunction (47.4%) were found. Reduced BOT retraction was correlated with clinical stage (p=0.011) and treatment modality (p=0.001). Aspiration in 42.1% and penetration in 33.3% of patients were observed. Twenty-four patients had PAS values over 6, implying aspiration. Forty-one patients had a SPS score of more than 3, 25 patients had a score greater than 5, and 13 patients had a SPS score of more than 7. Aspiration was found more often in patients with penetration (p=0.002) and in older patients (p=0.026). In older patients, abnormal swallowing caused aspiration even in those with a SPS score of more than 3, irrespective of stage or treatment, contrary to younger patients. Tube feeders (n=20) exhibited older age (65.0%), dysphagia/aspiration related structures (DARS) primaries (75.0%), higher stage disease (66.7%), and a history of radiotherapy (68.8%). Conclusion: Reduced BOT retraction was the most common dysphagia pattern and was correlated with clinical stage and treatmentregimens including radiotherapy. Aspiration was more frequent in patients who had penetration and in older patients. In contrast to younger patients, older patients showed greater risk of aspiration even with a single abnormal swallowing irrespective of stage or treatment.
#Head and neck cancer #dysphagia #modified barium swallow #radiotherapy #aspiration

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참고문헌 (21)

참고문헌 신청
/ 1991 / Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer / N Engl J Med 324 : 1685 ~ 1690 google schola Butler SG / 2010 / Factors influencing aspiration during swallowing in healthy older adults / Laryngoscope 120 : 2147 ~ 2152 google schola Dysphagia Section / 2012 / Swallowing dysfunction in cancer patients / Support Care Cancer 20 : 433 ~ 443 google schola Eisbruch A / 2004 / Dysphagia and aspiration after chemoradiotherapy for head-and-neck cancer: which anatomic structures are affected and can they be spared by IMRT? / Int J google schola Francis DO / 2010 / Dysphagia, stricture, and pneumonia in head and neck cancer patients:does treatment modality matter? / Ann Otol Rhinol Laryngol 119 : 391 ~ 397 google schola

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