Assessment of swallowing dysfunction using fees (flexible endoscopic evaluation of swallowing) in head and neck cancer patients undergoing radiotherapy

Abstract

The aim of this study is to evaluate swallowing dysfunction at baseline (before radiotherapy), at one month and three months post-radiotherapy and to assess time taken for these parameters to come back to normal in head and neck cancer patients. Total 30 patients who received radiotherapy for head and neck cancer, either as inpatients or outpatients, at Apollo Speciality Hospital, Chennai from June 2022 and May 2023 (1 year). Laryngeal sensation and pharyngeal swallowing before radiotherapy, at one month and three months post-radiotherapy assessed using penetration aspiration scale (PAS Scale), bolus residue scale (BRS Scale) and subjective assessment using eating assessment tool-10 (EAT-10) questionnaire and assess time it take to come to normal The EAT-10,PAS and BRS scores were analysed by multivariate analysis. All these scores showed a definite improvement from baseline (Before Radiotherapy) to three months Post-RT. Further more our study predicts the hazard ratio, through which the exact percentage and number of days of one variable compared with other variable, to come back to normal can be predicted. EAT-10 scores showed the influence of age and RT dose. More the age and higher the dose more time is taken for the scores to return back to normal. In PAS and BRS males took a longer time for the scores to come back to normal, whereas patients with >60 years of age (categorical) and every year increase in age (Continuous) took a longer time to return back to normal of PAS and BRS scores respectively. It is possible to predict the number of days it takes for the EAT-10, PAS and BRS score to return back to normal. So that we can initiate preventive measures like swallowing exercises, nutritional advise and Ryles tube insertion at the earliest for those who may develop swallowing complications, to enhance the quality of life for these patients.