Introduction:
Aspiration and limitation of oral intake, that is, dysphagia with the need for further
intervention (DFI), can occur in head-and-neck cancer patients already before the
onset of the oncological therapy. The study presented here scrutinized to what extent
such patients are aware of their swallowing disorder.
Methods:
In the years 2015 – 2017, 49 head-and-neck cancer patients (76% male; age 42 – 81
years, median 63, UICC stages I-IV) were included in the study. The patients' swallowing
functions were assessed by FEES® diagnostics. On the basis of FEES® results, the severity
of penetration/aspiration was determined by Rosenbek's scale (PAS), the limitation
of oral intake by Crary's FOIS scale, and DFI was determined under consideration of
both scales. All patients filled out the questionnaire EAT-10 to self-evaluate their
swallowing disorder.
Results:
According to FEES®, 35% of patients demonstrated DFI, 14% aspirated, and in 8% silent
aspiration was found. Limitations of oral intake were identified in 20% of the sample,
these patients were nourished by means of stomach tubes.
The median of the EAT-10 total score amounted to 11.0, the medians of single questionnaire
items ranged between 0 and 1.
Higher total scores of EAT-10 were significantly associated with the “fail” result
on the FOIS and DFI scales (Z = -3.8; Z = -2.4; p ≤0.015). In case of PAS, no significant
association was found.
Conclusions:
The patients' self-evaluation of limitation of oral intake can be considered reliable.
This was less often valid for the dysphagia with the need for further intervention.
For aspiration, the self-evaluation demonstrated very unreliable results.
