Fiber‐optic endoscopic evaluation of swallowing (FEES): Predictor of swallowing‐related complications in the head and neck cancer population

Deutschmann, Michael W.; McDonough, Alanna; Dort, Joseph C.; Dort, Erika; Nakoneshny, Steve; Matthews, T. Wayne

doi:10.1002/hed.23066

Cited by 31 publications

(19 citation statements)

References 37 publications

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“…A single prospective and two retrospective studies were conducted on dysphagia evaluation on a population comprising all tumor stages and sites. [11][12][13] This complication is under-diagnosed and often not treated properly, due to a lack of a uniform "gold standard" evaluation. In our cohort, clinical dysphagia (physician-reported) was present in almost 63% of patients.…”

Section: Discussionmentioning

confidence: 99%

Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients

Falewee

Hébert

Bénézery

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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Background: Dysphagia is a serious sequel of head and neck cancer (HNC) and its treatment. This dysfunction is frequent and likely underreported by clinical exam. It seems necessary to assess its global burden during the pre, per and post treatment periods (up to 18 months), regardless of the treatment received.Methods: This was a prospective cohort study assessing the rate of dysphagia in first-time treated HNC patients, using the deglutition handicap index questionnaire (DHI) and the clinician reporting. Time to occurrence, severity and length of the dysfunction were recorded. The benefit of an evaluation by the patient himself was investigated. Results: Of 134 evaluable patients: 22 were treated by surgery alone (16.4%), 16 by radiotherapy (RT) alone (11.9%), 3 by chemotherapy (CT) alone (2.2%), 28 by RTCT (20.9%), 31 by induction chemotherapy followed by RTCT (23.1%), 11 by surgery+RT (8.2%) and 23 by surgery+RTCT (17.2%). Patients completed 87.9% of the expected DHI. The dysphagia frequency reported was 92.2% by patient-reporting and 80.9% by clinicians-reporting, whatever the intensity. Self-perceived moderate to severe dysphagia was reported in 69.8% of patients.Conclusions: Given the strong impact of dysphagia on the quality of life and prognosis of HNC patients, it appears essential to perform screening and systematic monitoring. Using a simple and well accepted questionnaire, such as DHI, which is also well correlated with clinical evaluation, we demonstrated a significant frequency of dysphagia. The use of real-time patient-reported outcomes for its early detection would be an asset, particularly during long-term follow-up.Registered under ClinicalTrials.gov Identifier no. NCT03068559.

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Section: Discussionmentioning

confidence: 99%

Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients

Falewee

Hébert

Bénézery

et al. 2018

Int J Otorhinolaryngol Head Neck Surg

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“…Die Dyspha- gie tritt akut, manchmal auch erst nach Jahren (z. B. nach Bestrahlung) auf [30]. Hervorgerufen werden sie durch Substanzdefekte nach Entfernung von Gewebe wie Muskeln und Nerven, durch Narbenbildungen, durch Strikturen und durch die Veränderung der Umgebungsstrukturen.…”

Section: Fees Bei Strukturellen Dysphagienunclassified

Endoskopische Dysphagiediagnostik

Hörmann

Dziewas²,

Graf

et al. 2015

Endo heute

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Zusammenfassung Dysphagie ist ein weit gefasster Sammelbegriff f?r?Schluckst?rungen. Die differenzialdiagnostische Eingrenzung kann im klinischen Alltag bereits durch eine ausgiebige Anamnese und fachspezifische Untersuchung gelingen. Dennoch bedarf es zur diagnostischen Sicherung und Ausschluss von Differenzialdiagnosen weiterer apparativer Diagnostik. Mittlerweile steht uns eine Vielzahl von diagnostischen M?glichkeiten zur Verf?gung. In dieser ?bersicht soll die endoskopische Diagnostik detailliert dargestellt werden. Trotz moderner Bildgebung ist jedoch eine ausreichende klinische Expertise und m?glichst ein interdisziplin?res Gremium zur gemeinsamen Diskussion und Therapiefestlegung im t?glichen Alltag entscheidend.

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“…In total, 11 studies or reviews discussed dysphagia assessment [3,4,8,9,14,[18][19]21 && ,23,29-30] (Tables 3 and 4). …”

Section: Assessing Dysphagiamentioning

confidence: 99%

“…The described swallowing assessment tools include clinical, instrumental, subjective and global functional evaluations [3,4,8,9,14,[18][19]21 && ,23, 29-30]. Evaluation should start with clinical assessments (medical history and physical examination) to screen for dysphagia, identify possible cause, determine risk of aspiration, ascertain need for nonoral nutrition and recommend additional procedures [4,21 && ].…”

Section: Assessment Toolsmentioning

confidence: 99%

“…FEES is another appropriate method to assess dysphagia, which directly visualizes the pharyngeal swallowing phase by using transnasal endoscopy. Although observed rates of swallowing-related abnormalities are acceptable and appropriate dietary recommendations and rehabilitation programs can be formulated based on FEES observations, Deutschmann et al [18] reported that FEES is less suitable for predicting aspiration. Cine-MRI, described by Kreeft et al is another (additional) instrument to evaluate swallowing function in patients with oral/oropharyngeal cancer.…”

Section: Assessment Toolsmentioning

confidence: 99%

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Current assessment and treatment strategies of dysphagia in head and neck cancer patients

Kraaijenga

Molen

Brekel

et al. 2014

Current Opinion in Supportive &Amp; Palliative Care

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Regarding dysphagia evaluation, there is still a lack of a uniform 'gold-standard' for both assessment and treatment strategies. More high-quality data, adequately controlled, adequately powered and randomized, on prophylactic and therapeutic swallowing exercises are needed, with longer follow-up and better adherence to treatment, for better understanding the effects of chemo and radiotherapy dosage, and of frequency, timing and duration of treatment, to improve swallowing function and optimize quality of life.

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Fiber‐optic endoscopic evaluation of swallowing (FEES): Predictor of swallowing‐related complications in the head and neck cancer population

Abstract: Our experience is that FEES guides appropriate and safe diet recommendations in this population.

Cited by 31 publications

References 37 publications

Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients

Contribution of long-term dysphagia monitoring to first line treatment of head and neck cancer patients

Endoskopische Dysphagiediagnostik

Current assessment and treatment strategies of dysphagia in head and neck cancer patients

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