Gaziano Joy E
Speech Pathology Department, H. Lee Moffitt Cancer Center Research Institute, Tampa, Florida 33612, USA.
Cancer Control. 2002 Sep-Oct;9(5):400-9. doi: 10.1177/107327480200900505.
Dysphagia is a common symptom of head and neck cancer or sequelae of its management. Swallowing disorders related to head and neck cancer are often predictable, depending on the structures or treatment modality involved. Dysphagia can profoundly affect posttreatment recovery as it may contribute to aspiration pneumonia, dehydration, malnutrition, poor wound healing, and reduced tolerance to medical treatments.
The author reviewed the normal anatomy and physiology of swallowing and contrasted it with the commonly identified swallowing deficits related to head and neck cancer management. Evaluation methods and treatment strategies that can be used to successfully manage the physical and psychosocial effects of dysphagia are also reviewed.
Evaluation of dysphagia by the speech pathologist can be achieved with instrumental and noninstrumental methods. Once accurate identification of the deficits is completed, a range of treatment strategies can be applied that may return patients to safe oral intake, improve nutritional status, and enhance quality of life.
To improve safety of oral intake, normalize nutritional status, reduce complications of cancer treatment and enhance quality of life, accurate identification of swallowing disorders and efficient management of dysphagia symptoms must be achieved in an interdisciplinary team environment.
吞咽困难是头颈癌的常见症状或其治疗的后遗症。与头颈癌相关的吞咽障碍通常是可预测的，这取决于所涉及的结构或治疗方式。吞咽困难会严重影响治疗后的恢复，因为它可能导致吸入性肺炎、脱水、营养不良、伤口愈合不良以及对医疗治疗的耐受性降低。
作者回顾了吞咽的正常解剖结构和生理功能，并将其与头颈癌治疗中常见的吞咽缺陷进行了对比。还回顾了可用于成功管理吞咽困难的身体和心理社会影响的评估方法和治疗策略。
言语病理学家可通过仪器和非仪器方法对吞咽困难进行评估。一旦完成对缺陷的准确识别，就可以应用一系列治疗策略，这些策略可能使患者恢复安全的经口进食，改善营养状况，并提高生活质量。
为了提高经口进食的安全性，使营养状况正常化，减少癌症治疗的并发症并提高生活质量，必须在跨学科团队环境中准确识别吞咽障碍并有效管理吞咽困难症状。
