Ahmadi Aslan, Sanaei Ayda, Abedin Fatemeh, Salem Mohammad Mahdi
ENT and Head &Neck Research center, The Five senses Institute, Iran University of Medical Sciences, Tehran, 1445613131 Iran.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4448-4454. doi: 10.1007/s12070-024-04884-5. Epub 2024 Jul 13.
This study aims to assess the impact of supraglottic cancer on swallowing functionality and its anatomical correlations before and after laser surgery. The study seeks to determine the extent of score changes post-surgery, pinpoint the most influential anatomical component in swallowing, predict post-surgery outcomes, and ascertain the effect on patients' quality of life.
Patients with supraglottic cancer and dysphagia were identified through stroboscopy and indirect laryngoscopy. Exclusion criteria encompassed a history of prior radiotherapy, chemotherapy, or distant metastases. Demographic data, tumor stage, comorbidities, risk factors, and treatment details were documented. Swallowing evaluation employed the translated EAT10 self-assessment questionnaire, administered before and after transoral laser microsurgery (TLM) at baseline and 6 months later. Additional treatments, rehabilitation duration, NG tube use, and post-surgery complications were recorded.
At the six-month follow-up, 9 patients had EAT-10 scores ≥ 3, while 7 patients scored < 3. Five patients underwent post-TLM additional therapies, and 9 patients had neck dissections. Involved subunits were epiglottis (11 patients), arytenoid (5 patients), FVC (13 patients), and TVC (3 patients). Seven patients received dysphagia treatment. Analysis revealed significant associations between follow-up EAT-10 scores and dysphagia treatment ( = 0.04), smoking ( = 0.02), and FVC involvement ( = 0.02).
Our study on supraglottic cancer treatment with transoral laser microsurgery (TLM) revealed variable EAT-10 scores after a six-month follow-up. Adjunctive therapies and neck dissections were administered to some patients. Significant associations were found between follow-up scores, dysphagia treatment, smoking history, and FVC involvement, highlighting the complex interplay between interventions and patient factors. Further research is needed for optimization.
本研究旨在评估声门上癌对吞咽功能的影响及其在激光手术前后的解剖学相关性。该研究旨在确定手术后评分变化的程度，找出吞咽中最具影响力的解剖成分，预测手术后的结果，并确定对患者生活质量的影响。
通过频闪喉镜检查和间接喉镜检查确定患有声门上癌和吞咽困难的患者。排除标准包括既往放疗、化疗或远处转移史。记录人口统计学数据、肿瘤分期、合并症、危险因素和治疗细节。吞咽评估采用翻译后的EAT10自我评估问卷，在经口激光显微手术（TLM）前和基线时以及6个月后进行。记录额外的治疗、康复持续时间、鼻胃管使用情况和手术后并发症。
在六个月的随访中，9例患者的EAT-10评分≥3，而7例患者的评分<3。5例患者在TLM后接受了额外治疗，9例患者进行了颈部清扫术。受累亚单位为会厌（11例患者）、杓状软骨（5例患者）、室带（13例患者）和声带（3例患者）。7例患者接受了吞咽困难治疗。分析显示，随访EAT-10评分与吞咽困难治疗（=0.04）、吸烟（=0.02）和室带受累（=0.02）之间存在显著关联。
我们关于经口激光显微手术（TLM）治疗声门上癌的研究显示，六个月随访后EAT-10评分存在差异。一些患者接受了辅助治疗和颈部清扫术。随访评分、吞咽困难治疗、吸烟史和室带受累之间存在显著关联，突出了干预措施与患者因素之间复杂的相互作用。需要进一步研究以进行优化。
