Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center Maastricht, Maastricht, The Netherlands.
Laryngoscope. 2021 Jan;131(1):E45-E51. doi: 10.1002/lary.28626. Epub 2020 Apr 4.
The purpose of this study was to determine the relationship between patient-reported symptoms of oropharyngeal dysphagia (OD) using the Eating Assessment Tool (EAT)-10 and the swallowing function using a standardized fiberoptic endoscopic evaluation of swallowing (FEES) protocol in head and neck cancer (HNC) patients with confirmed OD.
Fifty-seven dysphagic HNC patients completed the EAT-10 and a FEES. Two blinded clinicians scored the randomized FEES examinations. Exclusion criteria consisted of presenting with a concurrent neurological disease, scoring below 23 on a Mini-Mental State Examination, being older than 85 years, having undergone a total laryngectomy, and being illiterate or blind. Descriptive statistics, linear regression, sensitivity, specificity, and predictive values were calculated.
The majority of the dysphagic patients (N = 38; 66.7%) aspirated after swallowing thin liquid consistency. A large number of patients showed postswallow pharyngeal residue while swallowing thick liquid consistency. More specifically, 42 (73.0%) patients presented postswallow vallecular residue, and 39 (67.9%) patients presented postswallow pyriform sinus residue. All dysphagic patients had an EAT-10 score ≥ 3. Linear regression analyses showed significant differences in mean EAT-10 scores between the dichotomized categories (abnormal vs. normal) of postswallow vallecular (P = .037) and pyriform sinus residue (P = .013). No statistically significant difference in mean EAT-10 scores between the dichotomized categories of penetration or aspiration was found (P = .966).
The EAT-10 questionnaire seems to have an indicative value for the presence of postswallow pharyngeal residue in dysphagic HNC patients, and a value of 19 points turned out to be useful as a cutoff point for the presence of pharyngeal residue in this study population.
2B.
本研究旨在确定头颈部癌症（HNC）吞咽困难患者报告的口咽吞咽困难（OD）症状与使用标准化光纤内镜吞咽评估（FEES）协议评估的吞咽功能之间的关系，患者采用吞咽评估工具（EAT-10）进行评估。
57 例吞咽困难的 HNC 患者完成了 EAT-10 和 FEES。两位盲法临床医生对随机 FEES 检查进行评分。排除标准包括患有并发神经疾病、简易精神状态检查得分低于 23 分、年龄超过 85 岁、行全喉切除术、以及失读或失明。计算了描述性统计、线性回归、敏感性、特异性和预测值。
大多数吞咽困难患者（N=38；66.7%）在吞咽稀薄液体后会发生呛咳。许多患者在吞咽浓稠液体时会出现吞咽后咽部残留物。更具体地说，42 例（73.0%）患者出现吞咽后会厌部残留物，39 例（67.9%）患者出现吞咽后梨状窝残留物。所有吞咽困难患者的 EAT-10 评分均≥3 分。线性回归分析显示，在吞咽后会厌（P=0.037）和梨状窝（P=0.013）残留物的二分类别中，EAT-10 评分的平均值存在显著差异。在穿透或吸入的二分类别中，EAT-10 评分的平均值没有统计学差异（P=0.966）。
EAT-10 问卷似乎对头颈部癌症吞咽困难患者吞咽后咽部残留物的存在具有指示价值，在本研究人群中，19 分被证明是有用的咽部残留物存在的截断值。
2B。
