Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Speech and Language Therapy Department, Sunderland Royal Hospital, Sunderland, UK.
Clin Otolaryngol. 2019 Jul;44(4):549-556. doi: 10.1111/coa.13331. Epub 2019 Apr 14.
Investigate the feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing (FEES) following a programme of prophylactic swallowing exercises in head and neck cancer (HNC) patients treated with radiotherapy.
Prospective, single cohort, feasibility study.
Three head and neck cancer centres in Scotland.
Pre-radiotherapy HNC patients who consented to participate in a prophylactic swallowing intervention.
Fibreoptic endoscopic evaluation of swallowing recruitment and retention rates, assessment acceptability and compliance, qualitative process evaluation.
Higher rates of recruitment and retention were achieved in centres where FEES equipment was available on-site. Travel and anticipated discomfort were barriers to recruitment. Data completion was high for all rating scales, with good reliability. Following radiotherapy, swallowing safety significantly deteriorated for liquid boluses (P = 0.005-0.03); pharyngeal residue increased for liquid and semi-solid boluses. Pharyngo-laryngeal oedema was present pre-treatment and significantly increased post-radiotherapy (P = 0.001). Patients generally reported positive experience of FEES for their own learning and establishing a baseline.
Fibreoptic endoscopic evaluation of swallowing is an acceptable method of assessing patients for a prophylactic swallowing intervention and offers some additional information missing from VF. Barriers have been identified and should be taken into account in order to maximise recruitment for future trials.
调查在头颈部癌症（HNC）患者接受放疗后进行预防性吞咽运动计划后，行纤维内镜吞咽检查（FEES）的可行性和结果。
前瞻性、单队列、可行性研究。
苏格兰的 3 个头颈部癌症中心。
同意参与预防性吞咽干预的放疗前 HNC 患者。
FEES 的招募和保留率、评估可接受性和依从性、定性过程评估。
在现场有 FEES 设备的中心，招募和保留率更高。旅行和预期的不适是招募的障碍。所有评分量表的数据完成率都很高，具有良好的可靠性。放疗后，液体团块的吞咽安全性显著恶化（P=0.005-0.03）；液体和半固体团块的咽部残留增加。治疗前存在咽-喉水肿，放疗后明显增加（P=0.001）。患者通常报告 FEES 对他们自身学习和建立基线的积极体验。
纤维内镜吞咽检查是评估预防性吞咽干预患者的一种可接受的方法，它提供了 VF 中缺失的一些额外信息。已经确定了障碍，在未来的试验中应考虑这些障碍，以最大限度地提高招募率。
