Department of Otorhinolaryngology, Ophtalmology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of ENT, Head and Neck Surgery, Coltea Clinical Hospital, 030167 Bucharest, Romania.
Curr Oncol. 2024 Nov 2;31(11):6853-6866. doi: 10.3390/curroncol31110506.
This study aims to determine the efficacy of prophylactic swallowing exercises on swallowing function in patients undergoing total laryngectomy for laryngeal cancer.
The design was a randomized controlled trial set in one tertiary care academic medical center. A total of 92 patients undergoing total laryngectomy for stages III and IV laryngeal cancer performed five targeted swallowing exercises for a period of three months after their surgery, starting two weeks after the surgery. Weekly swallowing therapy sessions were held with the patients in order to encourage adherence and proper technique. The controls received no preventive exercise and were referred for swallowing treatment following the surgery, as well as radiation therapy if necessary. The Functional Oral Intake Scale (FOIS) and the Performance Status Scale for Head and Neck Cancer Patients (PSS-H&N) were used to measure swallowing function at the baseline, one week following the surgery, and three, six, nine, and twelve months following the surgery.
Right after the surgery, there were no statistically significant variations between the intervention and control groups in the FOIS scores ( value = 0.64), the Eating in Public subscale scores ( value = 1) and Normalcy of Diet subscale scores ( = 0.33) of the PSS-H&N. The scores were significantly better among the intervention patients at months 3, 6, 9, and 12 for all the scores, with values smaller than 0.000.
Although not immediately following the surgery, the patients who engaged in prophylactic swallowing exercises showed improvements in their ability to swallow at 3, 6, 9, and 12 months following their procedure.
本研究旨在确定预防性吞咽练习对喉癌全喉切除术后吞咽功能的疗效。
该研究设计为单中心、随机对照试验。共纳入 92 例接受全喉切除术的 III 期和 IV 期喉癌患者，术后两周开始进行为期三个月的五项靶向吞咽练习。每周为患者进行吞咽治疗，以鼓励他们坚持并采用正确的技术。对照组未接受预防性运动，仅在术后以及必要时进行放射治疗后才接受吞咽治疗。采用功能性口腔摄入量表（FOIS）和头颈部癌症患者表现状态量表（PSS-H&N）在基线、术后一周以及术后 3、6、9 和 12 个月时评估吞咽功能。
术后即刻，干预组和对照组在 FOIS 评分（ 值=0.64）、PSS-H&N 的“在公共场所进食”子量表评分（ 值=1）和“饮食正常”子量表评分（ 值=0.33）方面均无统计学差异。在术后 3、6、9 和 12 个月时，干预组的所有评分均显著优于对照组， 值均小于 0.000。
尽管在术后即刻并未立即改善，但进行预防性吞咽练习的患者在术后 3、6、9 和 12 个月时吞咽能力有所提高。
