Lee Mary T, Govender Roganie, Roy Penny J, Vaz Francis, Hilari Katerina
Head and Neck Centre, University College London Hospital, London, UK.
Research Department of Behavioural Science and Health, University College London, London, UK.
Head Neck. 2020 Aug;42(8):1963-1969. doi: 10.1002/hed.26132. Epub 2020 Mar 2.
Little is known about what factors affect patient-reported swallowing outcome after total laryngectomy. We explored whether patient demographics, surgical variables, use of adjuvant treatment, and time since surgery were associated with patient-reported swallowing outcome.
Cross-sectional study of laryngectomees in eight UK hospitals. Demographic, treatment, and surgical variables were drawn from medical notes. The swallowing outcomes after laryngectomy (SOAL) questionnaire captured perceived swallowing outcome.
Two hundred and twenty one participants had complete data on treatment-related variables. In regression analysis, having a free jejunum flap repair and requiring chemoradiation were the only two variables that added significantly to the model of worse self-reported swallowing outcome (R adjusted = .23, P < .001).
The SOAL is a sensitive measure of self-reported swallowing outcome after laryngectomy. Type of surgical closure and the type of additional treatment influenced the swallowing outcome reported by patients. Changes in perceived swallowing function need to be routinely evaluated to inform clinical decision-making and intervention.
对于全喉切除术后哪些因素会影响患者报告的吞咽结果知之甚少。我们探讨了患者人口统计学特征、手术变量、辅助治疗的使用以及术后时间是否与患者报告的吞咽结果相关。
对英国八家医院的喉切除患者进行横断面研究。人口统计学、治疗和手术变量来自病历。喉切除术后吞咽结果（SOAL）问卷收集了患者感知的吞咽结果。
221名参与者有关于治疗相关变量的完整数据。在回归分析中，进行游离空肠瓣修复和需要放化疗是仅有的两个能显著增加自我报告吞咽结果较差模型的变量（调整后R = 0.23，P < 0.001）。
SOAL是喉切除术后自我报告吞咽结果的敏感指标。手术闭合类型和额外治疗类型影响患者报告的吞咽结果。需要常规评估感知吞咽功能的变化，为临床决策和干预提供依据。
