Am J Otolaryngol Head Neck Surg | Volume 3, Issue 6 | Research Article | Open Access
Laishyang Melody Ouyoung1*, Margaret Nurimba1, Mark Swanson2, Franklin Wu1, Ryan Zilter1, Susie Nam3, Brenda Caprobres Villegas3 and Uttam Sinha2
1Keck School of Medicine of the University of Southern California, USA
2Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine of the University of Southern
California, USA
3Department of Speech Pathology, Keck Medical Center of the University of Southern California, USA
*Correspondance to: Laishyang Melody Ouyoung
Fulltext PDFObjectives: To evaluate the impact of Dysphagia Boot Camp (DBC) swallowing intervention timing on functional swallowing outcomes after treatment of oropharyngeal cancer.
Study Design: Retrospective cohort study at a single academic tertiary care center between 2007 to 2018.
Methods: Patients who underwent dysphagia therapy after treatment of oropharyngeal cancer were identified on retrospective chart review and stratified into three cohorts based on tumor management: (1) primary Chemoradiation (CRT), (2) Transoral Robotic Surgery with adjuvant CRT (TORS), (3) free tissue transfer and Flap reconstruction with adjuvant CRT (Flap). The timing
of dysphagia therapy intervention was defined as “early” if less than, or “late” if greater than 26 weeks after primary resection date or completion of chemoradiation. The primary outcome of the study was to assess the impact of Dysphagia Boot Camp (DBC) intervention timing on differences in Functional Oral Intake Scores (FOIS) after dysphagia boot camp therapy.
Results: A total of 32 patients (TORS, n=10; Flap, n=12; CRT, n=10) were included in the analysis. There were significant differences in pre-therapy FOIS (p=0.010) between cohorts, with TORS patients having greater FOIS than flap and CRT patients prior to DBC therapy. DBC therapy alone resulted in significant improvements in FOIS score regardless of primary treatment arm (TORS, p=0.002; Flap, p=0.027; CRT, p=0.019). When adjusting for timing of therapy, early DBC therapy was associated with significant improvement in FOIS score for the TORS (Z=2.060, p=0.039) and flap (Z=2.205, p=0.027) cohorts.
Conclusion: While primary chemoradiation and extensive surgical resection of oropharyngeal cancers are associated with poorer functional swallowing outcomes, early DBC therapy is associated with increased improvement in FOIS scores. This highlights the need for early referral and engagement in swallow rehabilitation after treatment of oropharyngeal cancers.
Oropharyngeal cancer; FOIS; Swallow intervention; Rehabilitation
Ouyoung LM, Nurimba M, Swanson M, Wu F, Zilter R, Nam S, et al. Timing of Using Exercise-Based Dysphagia Boot Camp (DBC) Impacts Functional Swallowing Outcomes after Surgical Management of Oropharyngeal Cancer. Am J Otolaryngol Head Neck Surg.2020; 3(6): 1108..