Validity of a dysphagia screening test following resection for head and neck cancer

Horii, Nobuhide; Hirabayashi, Yoko; Sakuramoto-Sadakane, Ayumi; Saito, Shyota; Nanto, Tomoki; Nakao, Yasuaki; Domen, Kazuhisa; Ono, Takahiro; Kishimoto, Hiroyuki

doi:10.1007/s11845-020-02286-4

Cited by 11 publications

(15 citation statements)

References 30 publications

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“…The dysphagia screening tests were performed according to the evaluation criteria of the Japanese Society of Dysphagia Rehabilitation. We performed the repetitive saliva-swallowing test (RSST) [ 6 , 15 , 16 ] and water-swallowing test (WST) [ 6 , 17 ] ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…The time taken to empty the cup was measured, and the drinking profile and episodes were monitored and evaluated as: (1) the patient could drink all of the water in one gulp without coughing; (2) the patient could drink all of the water in two or more gulps without coughing; (3) the patient could drink all of the water in one gulp, but with some coughing; (4) the patient could drink all of the water in two or more gulps, with some coughing; or (5) the patient often coughed and had difficulty drinking all of the water [18]. The RSST is used to study the ability of the patient to spontaneously and repeatedly swallow, which is highly associated with aspiration [6,15,16]. The RSST is a simple test and relatively safe to carry out.…”

Section: Dysphagia Screening Testsmentioning

confidence: 99%

“…It is well known that there is a correlation between pre-HNC resection nutritional status/immune status and post-HNC resection complication rate/postoperative recovery [ 5 ]. To date, we have conducted continuous assessments of the dysphagia status in patients who underwent HNC resection and reported changes in their dysphagia status [ 6 , 7 ]. We have reported that among HNC resection patients, those with suprahyoid muscle group resection [ 7 ], advanced cancer [ 6 ], and those who have combined radiation therapy, cervical dissection, and reconstruction are more likely to have dysphagia.…”

Section: Introductionmentioning

confidence: 99%

“…To date, we have conducted continuous assessments of the dysphagia status in patients who underwent HNC resection and reported changes in their dysphagia status [ 6 , 7 ]. We have reported that among HNC resection patients, those with suprahyoid muscle group resection [ 7 ], advanced cancer [ 6 ], and those who have combined radiation therapy, cervical dissection, and reconstruction are more likely to have dysphagia. As the ingesting/swallowing function of HNC patients is greatly reduced immediately after surgery, the risk of aspiration is high immediately after surgery [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…We have reported that among HNC resection patients, those with suprahyoid muscle group resection [ 7 ], advanced cancer [ 6 ], and those who have combined radiation therapy, cervical dissection, and reconstruction are more likely to have dysphagia. As the ingesting/swallowing function of HNC patients is greatly reduced immediately after surgery, the risk of aspiration is high immediately after surgery [ 6 , 7 ]. Furthermore, regarding dysphagia after HNC surgery, it is known that oral function will be restored, thereby leading to weight gain and improvement of nutritional status, by performing appropriate intervention after HNC resection, such as performing treatments for palatal augmentation prosthesis and jaw prosthodontic [ 8 ], in addition to performing feeding/swallowing rehabilitation [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Change in Nutritional Status and Dysphagia after Resection of Head and Neck Cancer

et al. 2021

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Nutritional status is well-known to influence patient recovery after resection of head and neck cancer (HNC). The influence of preoperative nutritional status on dysphagia was assessed in patients who underwent surgical resection of HNC along with the assessment of nutritional status during the acute and subacute phases. Eighty-six patients underwent surgical resection and dysphagia assessments (repetitive saliva-swallowing test, water-swallowing test, and functional oral intake scale) and had their tongue pressure assessed five times (before surgery, after 1–2 weeks, and 1, 2, and 3 months after surgery). The nutritional status was assessed according to the body mass index, total protein, and albumin. The prognostic nutritional index was calculated from preoperative data, and the subjects were classified into three groups: Low-risk, Attention and High-risk groups. After surgery, the nutritional status index values were low, and the High-risk group showed significantly lower values in comparison to the other two groups. The water-swallowing test and functional oral intake scale findings were worse than they had been preoperatively until 2 months after surgery, and a significant correlation was noted between the postoperative nutritional status and the presence of dysphagia. The results indicated that the preoperative nutritional status of HNC patients influenced their ability to ingest/swallow, which in turn influenced their nutritional status after HNC resection.

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Section: Methodsmentioning

confidence: 99%

Section: Dysphagia Screening Testsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Change in Nutritional Status and Dysphagia after Resection of Head and Neck Cancer

et al. 2021

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Diagnostic value of water swallow test for dysphagia in patients with head and neck cancer: A systematic review and meta‐analysis

Zhang,

Wang,

Zhu

et al. 2024

Head & Neck

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The diagnostic efficacy of the water swallow test (WST) is relatively robust for patients with neurogenic dysphagia; however, its diagnostic performance in identifying dysphagia among patients with HNC varies across studies. Our study aims to assess the diagnostic value of the WST for detecting dysphagia in patients with HNC. Systematic retrieval of studies on the use of WST for screening dysphagia in patients with HNC from databases up to August 1, 2023. Quality assessment of the included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool. Calculate the pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) to evaluate the screening ability of WST for dysphagia. A total of seven articles, encompassing eight study groups, were included, involving the analysis of 691 patients. The meta‐analysis results demonstrate that the WST has a combined sensitivity, specificity, positive LR, negative LR, DOR, and AUC for diagnosing dysphagia in patients with HNC of 0.82 (95% CI [0.64, 0.92]), 0.79 (95% CI [0.70, 0.86]), 4.00 (95% CI [2.51, 6.36]), 0.22 (95% CI [0.10, 0.50]), 17.94 (95% CI [5.56, 57.92]), and 0.86 (95% CI [0.83, 0.89]), respectively. Significant heterogeneity was observed among the included studies. Meta‐regression analysis showed that the pooled sensitivity of tumor sites and treatment was closely related, while the pooled specificity of treatment and version was closely related. The subgroup analysis showed that the WST's pooled sensitivity for diagnosing dysphagia in patients with nasopharyngeal cancer was 0.40 (95% CI [0.26, 0.56]), with an AUC of 0.50, lower than in other HNC sites. The WST performed better in surgical patients than in those undergoing radiotherapy (RT) or chemoradiotherapy (CRT), with lower sensitivity, specificity, and AUC values of 0.49 (95% CI [0.36, 0.61]), 0.66 (95% CI [0.59, 0.72]), and 0.64, respectively, for RT or CRT patients. The modified WST version showed different specificity values of 0.82 (95% CI [0.75, 0.87]), compared to the regular version of 0.68 (95% CI [0.61, 0.74]). Additionally, Deek's test indicated the absence of publication bias in this study (p = 0.32). The WST demonstrates favorable sensitivity and specificity in detecting dysphagia among patients with HNC. However, the diagnostic value may vary depending on factors such as tumor sites, treatment, and the specific version of the WST used.

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FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

Hey

Goeze

Sader

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Oropharyngeal dysphagia is one of the most common postoperative consequences in head and neck cancer patients. Above all, these patients often suffer from aspiration and limitations of oral intake. However, no reliable dysphagia screening is available for this target group. This study aimed to develop and validate a screening, FraMaDySc, based on a water swallow test (WST) for the identification of postsurgical patients with a risk of aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia in general (OD) that constituted the main reference standard. Methods A total of 184 postsurgical head and neck cancer patients were tested with a WST. The patients were, on average, 62 years old and predominantly male (71%). After WST, they underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). FEES® results were dichotomized by Penetration aspiration scale and Functional oral intake scale. Patients with a “fail” result on one of these two scales were classified as having OD. Quality criteria of WST were quantified by means of cross-tabulation with FEES® results. Results OD was found in 65% of patients, aspiration in 44%, limitations of oral intake in 56%. WST delivered a “fail” result in 65% of patients. WST showed sensitivity 91% and specificity 88% for OD. Quality criteria for aspiration (sensitivity 64%, specificity 93%) and limitations of oral intake (sensitivity 80%, specificity 87%) were lower. Conclusion FraMaDySc is a standardized, quick, and valid WST and therefore an excellent screening tool for the identification of OD in postoperative head and neck cancer patients.

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Validity of a dysphagia screening test following resection for head and neck cancer

Cited by 11 publications

References 30 publications

Change in Nutritional Status and Dysphagia after Resection of Head and Neck Cancer

Change in Nutritional Status and Dysphagia after Resection of Head and Neck Cancer

Diagnostic value of water swallow test for dysphagia in patients with head and neck cancer: A systematic review and meta‐analysis

FraMaDySc: dysphagia screening for patients after surgery for head and neck cancer

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