Electrical Stimulation for Treatment of Dysphagia Post Head Neck Cancer: A Systematic Review and Meta-Analysis

IF 1 Q3 OTORHINOLARYNGOLOGY International Archives of Otorhinolaryngology Pub Date : 2023-09-14 DOI:10.1055/s-0043-1761175
Émille Dalbem Paim, Lica Arakawa Sugueno, Vera Beatris Martins, Virgilio Gonzales Zanella, Fabricio Edler Macagnan
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Abstract

Abstract Introduction Dysphagia induced by radiotherapy in the head and neck region comprises a challenging scenario and sometimes difficult rehabilitation due to the severity of the adverse effects. Some resources such as electrical stimulation have emerged as an alternative to complement the therapeutic process, but there is still no consensus on its use. Objective The purpose of the present study was to evaluate, through a meta-analysis, the effect of electrical stimulation on the rehabilitation of dysphagia generated after head and neck cancer treatment. Data Synthesis Four randomized controlled trials with a total of 146 participants were included. The age of the participants was 58.37 ± 1.8 years old and there was a predominance of males. The time to start the intervention ranged from 50.96 ± 40.12 months after cancer treatment. The intervention showed great heterogeneity regarding the positioning of the electrodes, parameters, duration of the stimulus, number of sessions, and intensity. No difference was identified in the following aspects: oral transit time, hyoid elevation, penetration and/or aspiration after electrostimulation. The quality of the evidence ranged from very low to moderate and high risk of bias. Conclusion: In this meta-analysis, we found weak evidence for small and moderate swallowing benefits in patients after radiotherapy for head and neck cancer in short-term clinical trials.
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电刺激治疗头颈癌后吞咽困难:系统回顾和荟萃分析
头颈部放疗引起的吞咽困难是一个具有挑战性的场景,由于不良反应的严重性,有时难以康复。一些资源,如电刺激,已经成为一种补充治疗过程的替代方法,但对其使用仍未达成共识。目的通过荟萃分析,评价电刺激对头颈癌治疗后出现的吞咽困难的康复效果。纳入4项随机对照试验,共146名受试者。年龄58.37±1.8岁,男性居多。开始干预的时间为癌症治疗后50.96±40.12个月。干预在电极的位置、参数、刺激持续时间、会话次数和强度方面显示出很大的异质性。电刺激后的口腔传递时间、舌骨抬高、渗透和/或吸入等方面均无差异。证据的质量从极低到中等偏倚风险和高偏倚风险不等。结论:在这项荟萃分析中,我们发现在短期临床试验中,头颈癌放疗后患者有少量和中度吞咽益处的证据不足。
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CiteScore
2.80
自引率
0.00%
发文量
84
审稿时长
12 weeks
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