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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(03): e357-e364
DOI: 10.1055/s-0041-1730306
Original Research

DIGEST Scale Predictis More Quality of Life Than PAS: The Residue Influence on Supracricoid Laryngectomy

Andressa Silva de Freitas 
1   Departamento de Cirurgia de Cabeça e Pescoço, Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
,
Guilherme Maia Zica 
1   Departamento de Cirurgia de Cabeça e Pescoço, Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
,
Mariana Salles 
1   Departamento de Cirurgia de Cabeça e Pescoço, Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
,
Ana Catarina Alves e Silva 
1   Departamento de Cirurgia de Cabeça e Pescoço, Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
,
Thiago Huaytalla Silva 
2   Departamento de Nutrição e Dietética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
,
Fernando Luiz Dias 
1   Departamento de Cirurgia de Cabeça e Pescoço, Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
,
Izabella Costa Santos 
1   Departamento de Cirurgia de Cabeça e Pescoço, Instituto Nacional do Câncer, Ministério da Saúde, Rio de Janeiro, RJ, Brazil
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Abstract

Introduction Supracricoid laryngectomy (SCL CHEP) removes ∼ 70% of the larynx, resulting in structural rearrangement and modification of the swallowing mechanism, promoting chronic dysphagia. One of the consequences of this new physiology is the formation of pharyngeal residues that can increase the possibility of aspiration. The formation of residues after SCL CHEP, its functional consequences, and its influence on quality of life (QOL) is still poorly described in the literature.

Objective To investigate and compare the association between self-reported QoL and objective assessments of swallowing function in patients undergoing SCL CHEP.

Methods A cross-sectional study was performed from 2018 to 2020 in a reference service for head and neck surgery in Brazil. A total of 860 swallowing videofluoroscopy images were evaluated using the Penetration and Aspiration Scale (PAS) and Dynamic Imaging Grade of Swallowing Toxicity (DIGEST).

Results In a group of 86 patients, there was a significant relationship between oncological staging and the global (p < 0.001) and total (p = 0.002) QoL domains. There was a negative correlation between the DIGEST scale and the emotional domain of the QoL protocol (p = 0.045). The swallowing function proved to be relevant for QoL.

Conclusion The PAS scale did not show any correlation with QoL. The functional performance of swallowing according to the DIGEST scale was coherent with the QOL scores. It is suggested that the residue may be a more relevant aspect for QoL than the aspiration, making DIGEST a promising tool in the assessment of dysphagic patients.

Keywords

rehabilitation - radiology - deglutition disorders - laryngectomy - quality of life

Study performed at the Interdisciplinary Head and Neck Laboratory (Laboratório Interdisciplinar de Cabeça e Pescoço - LICEP) of the National Cancer Institute (Instituto Nacional de Câncer - INCA), Ministry of Health, Rio de Janeiro, RJ, Brazil




Publication History

Received: 05 June 2020

Accepted: 07 January 2021

Article published online:
03 November 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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