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DOI: 10.1055/s-0041-1730306
DIGEST Scale Predictis More Quality of Life Than PAS: The Residue Influence on Supracricoid Laryngectomy
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.
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
Publikationsverlauf
Eingereicht: 05. Juni 2020
Angenommen: 07. Januar 2021
Artikel online veröffentlicht:
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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