Introduction
Both CO2 transoral laser microsurgery (CO2 TOLMS) and radiotherapy (RT) are standard of care in early glottic carcinoma. However, previous studies focus on voice outcomes rather than swallowing outcomes. This study aimed to compare the late post‐treatment effects of CO2 TOLMS and RT treatment on swallowing function in T1 glottic carcinoma.
Methods
Forty patients (20 CO2 TOLMS and 20 RT) with T1 glottic cancer between May 2015 and January 2019 were included. Certain types of foods triggering dysphagia, any difficulties in bolus control, need to clean the throat, the sensation of lumping in the throat, choking, cough and xerostomia were questioned. Also, functional oral intake scale (FOIS), functional outcome swallowing scale (FOSS), Eating Assessment Tool‐10 test (EAT‐10) and flexible fiberoptic endoscopic examination of swallowing (FEES) findings were assessed.
Results
CO2 TOLMS patients performed significantly better than the RT group regarding penetration and aspiration with 10 and 20 mL water according to the Penetration and Aspiration Scale (P < .05). The mean EAT‐10 Score was found 0 in the CO2 TOLMS group, and 3.20 ± 3.24 in the RT group (P < .05) (lower score indicates a better outcome). According to the Yale Pharyngeal Residue Severity Scale for vallecula, there was no statistically significant difference in vallecular residue between the groups (P > .05). A significantly lesser residue in piriform sinus was detected in the CO2 TOLMS group compared to the RT group with 5 mL and 10 mL water, 5 mL and 20 mL honey consistency food and yogurt according to Yale Pharyngeal Residue Severity Scale (P < .05).
Conclusion
It is suggested that in the long term, CO2 TOLMS is more advantageous regarding swallowing function in the treatment of T1 glottic cancer.
Objectives
To evaluate swallowing function in relation to oropharyngeal dysphagia (OD) in adolescents who had transverse maxillary deficiency with posterior crossbite and high-arched palate, before, and after rapid maxillary expansion (RME).
Materials and Methods
Twenty patients (mean age: 13.0 ± 3.1) with bilateral posterior crossbite and high-arched palate (RME group: RMEG) and 20 volunteers (mean age: 13.4 ± 2.6) with Class I crowding without posterior crossbite or high-arched palate (control group: CG) were recruited. OD signs and symptoms were evaluated using the Eating Assessment Tool-10 (EAT-10) questionnaire, patient complaints, and physical examination of swallowing function before (T1) and 7 months after (T2) RME. Additionally, fiberoptic endoscopic evaluation of swallowing (FEES) with water, yogurt, and cracker was performed. In CG, evaluation of swallowing was performed only once, corresponding to T1 of RMEG.
Results
Prevalence of OD signs and symptoms based on patient complaints and physical examination of swallowing was low (5%–15%), and nonsignificant differences were observed between CG and RMEG at T1 for these parameters as well as for EAT-10 scores. Total post-swallow pharyngeal residue with yogurt was significantly different between CG and RMEG at T1, with a prevalence of 60% in RMEG (P < .05). There was no significant difference regarding residue with yogurt between T1 and T2 in RMEG (P > .05).
Conclusion
Patients with a maxillary transverse deficiency were affected by pharyngeal residue as indicated by FEES, but it did not appear to improve in short-term follow-up in patients treated with RME.
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