Lazarus Cathy L, Ganz Cindy, Ru Meng, Miles Brett A, Kotz Tamar, Chai Raymond L
THANC Foundation, New York, New York.
Departments of Otolaryngology-Head & Neck Surgery, Mount Sinai Health System, New York, New York.
Head Neck. 2019 Feb;41(2):322-328. doi: 10.1002/hed.25455. Epub 2018 Dec 15.
Transoral robotic surgery (TORS) has been utilized to deintensify treatment. No studies have measured swallow safety and efficiency, nor assessed the functional impact of TORS alone.
This prospective cohort underwent baseline and 1-month postsurgery assessments including modified barium swallow evaluation, using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) rating system, tongue range of motion assessment, the Performance Status Scale (PSS), and quality of life with the MD Anderson Dysphagia Inventory (MDADI).
All DIGEST safety scores were 0 (normal) at both time points. DIGEST efficiency scores were mildly impaired in 2 of 10 patients postsurgery. PSS scores revealed all patients were on regular diets, were 100% understandable, and were eating in public at both time points. Tongue Range of Motion scores were 100 of 100 at both time points. MDADI scores were not significantly different across time points.
Careful identification of patients can result in excellent outcomes following TORS. Future studies will examine longer follow-up of speech, swallowing, and tongue function in patients undergoing TORS surgery.
经口机器人手术(TORS)已被用于强化治疗。尚无研究测量吞咽安全性和效率,也未单独评估TORS的功能影响。
该前瞻性队列进行了基线和术后1个月评估,包括使用吞咽毒性动态成像分级(DIGEST)评分系统的改良钡餐吞咽评估、舌运动范围评估、性能状态量表(PSS)以及使用MD安德森吞咽障碍量表(MDADI)评估生活质量。
两个时间点的所有DIGEST安全评分均为0(正常)。术后10例患者中有2例的DIGEST效率评分轻度受损。PSS评分显示,两个时间点所有患者均正常饮食,表达完全可理解,且在公共场合进食。两个时间点的舌运动范围评分均为满分100分。MDADI评分在各时间点无显著差异。
仔细筛选患者可使TORS术后获得良好疗效。未来研究将对接受TORS手术患者的言语、吞咽和舌功能进行更长时间的随访。