Fiberoptic endoscopic evaluation of swallow as a tool to facilitate dysphagia rehabilitation following a salvage hemi-glossectomy: Case report

Background: Dysphagia is a common consequence of tongue cancer and its treatment, with the possibility of long-term diet modification and feeding tube dependence. This is likely to have an impact on the activity, participation and psychological wellbeing of the individual. Objective: This case report presents the use of fiberoptic endoscopic evaluation of swallow (FEES) as a tool to support dysphagia rehabilitation through providing visual feedback following a salvage hemi-glossectomy for management of a recurrent squamous cell carcinoma (SCC) in the right anterolateral tongue. Methods: Clinician-rated and patient-reported outcome measures were used to assess the effectiveness of FEES as a tool to facilitate dysphagia rehabilitation. These measures include the: Performance Status Scale for Head and Neck (PSS-HN) cancer patients, 100 mL water swallow test (WST), Penetration-Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale, and the Functional Intraoral Glasgow Scale (FIGS). Results: No Statistical tests were performed on this single case, however the results demonstrate a notable clinical improvement in all postoperative outcome measures at 12-months when compared with those taken two-months postoperatively. Conclusion: Use of sequential FEES could enhance patient engagement and inform dysphagia rehabilitation following hemi-glossectomy.