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Research ArticleClinical Studies

Water Swallow Screening Test for Patients After Surgery for Head and Neck Cancer: Early Identification of Dysphagia, Aspiration and Limitations of Oral Intake

CHRISTIANE HEY, BENJAMIN P. LANGE, SILVIA EBERLE, YEVGEN ZARETSKY, ROBERT SADER, TIMO STÖVER and JENS WAGENBLAST
Anticancer Research September 2013, 33 (9) 4017-4021;
CHRISTIANE HEY
1Department of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Frankfurt/Main, Germany
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  • For correspondence: Christiane.Hey@kgu.de
BENJAMIN P. LANGE
2Institute of Medical Psychology and Medical Sociology, Center of Psychosocial Medicine, Faculty of Medicine, University of Göttingen, Göttingen, Germany
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SILVIA EBERLE
1Department of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Frankfurt/Main, Germany
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YEVGEN ZARETSKY
1Department of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Frankfurt/Main, Germany
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ROBERT SADER
3Department of Oral, Cranio-, Maxillofacial and Facial Plastic Surgery, University of Frankfurt/Main, Frankfurt/Main, Germany
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TIMO STÖVER
4Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Frankfurt/Main, Frankfurt/Main, Germany
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JENS WAGENBLAST
4Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Frankfurt/Main, Frankfurt/Main, Germany
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Abstract

Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC.

  • Dysphagia
  • swallowing disorder
  • head and neck cancer
  • postsurgical
  • screening
  • Received May 30, 2013.
  • Revision received July 9, 2013.
  • Accepted July 10, 2013.
  • Copyright© 2013 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved
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Anticancer Research: 33 (9)
Anticancer Research
Vol. 33, Issue 9
September 2013
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Water Swallow Screening Test for Patients After Surgery for Head and Neck Cancer: Early Identification of Dysphagia, Aspiration and Limitations of Oral Intake
CHRISTIANE HEY, BENJAMIN P. LANGE, SILVIA EBERLE, YEVGEN ZARETSKY, ROBERT SADER, TIMO STÖVER, JENS WAGENBLAST
Anticancer Research Sep 2013, 33 (9) 4017-4021;

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Water Swallow Screening Test for Patients After Surgery for Head and Neck Cancer: Early Identification of Dysphagia, Aspiration and Limitations of Oral Intake
CHRISTIANE HEY, BENJAMIN P. LANGE, SILVIA EBERLE, YEVGEN ZARETSKY, ROBERT SADER, TIMO STÖVER, JENS WAGENBLAST
Anticancer Research Sep 2013, 33 (9) 4017-4021;
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Keywords

  • dysphagia
  • swallowing disorder
  • Head and neck cancer
  • postsurgical
  • screening
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