Department of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Theodor-Stern-Kai 7, House 7A, D-60590 Frankfurt/Main, Germany.
Anticancer Res. 2013 Sep;33(9):4017-21.
Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC.
头颈部癌症（HNC）患者在接受手术治疗后，发生口咽吞咽困难（OD）的风险很高。早期识别 OD 可以改善预后并降低经济负担。本研究旨在评估一种水筛选测试在 HNC 患者（N=80）中的有效性，该测试在术后使用递增容量来评估 OD 的早期识别，以及是否需要进一步的仪器诊断来研究有无误吸以及确定纤维内镜吞咽评估定义的经口摄入的限制。一般情况下，OD 的检出率为 65%，误吸为 49%，无声误吸为 21%，经口摄入受限为 56%。尽管水筛选测试的灵敏度对于误吸和经口摄入受限分别为 100%和 97.8%，但由于其阳性似然比较低（误吸=2.6；经口摄入受限=3.1），其并不能很好地预测这两个参考标准。然而，它是一种用于早期识别 HNC 术后患者 OD 的准确工具，其敏感性为 96.2%，阳性似然比为 5.4。
