RESUMEN
This work aimed at evaluating patients' swallowing functions by a newly validated swallow-specific questionnaire, the Sydney Swallow Questionnaire (SSQ), in a cohort of oral and oropharyngeal cancer patients. Mean/median SSQ scores were calculated and compared with study variables using the Mann-Whitney U test and Kruskal-Wallis test. The mean composite SSQ scores (SD) for the base of tongue, oral tongue, and tonsillar cancer patients were 663.8 (382.8), 456.2 (407.6), and 283.0 (243.1), respectively (p = 0.005); for advanced vs. early T stage disease they were 918.1 (319.5) vs. 344.8 (292.1) (p ≤ 0.001); for patients <60 years vs. ≥60 years they were 549.3 (415.1) vs. 314.0 (247.3) (p = 0.02); and for patients with reconstruction vs. without reconstruction they were 676.5 (410.5) vs. 331.9 (286.5) (p = 0.002). SSQ is a useful tool for evaluation of swallowing in head and neck cancer patients. Site of cancer, T stage, patient's age, and reconstruction directly affect post-treatment swallow outcome.
Asunto(s)
Trastornos de Deglución/fisiopatología , Deglución/fisiología , Neoplasias Orofaríngeas/fisiopatología , Encuestas y Cuestionarios , Estudios Transversales , Trastornos de Deglución/epidemiología , Trastornos de Deglución/etiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neoplasias Orofaríngeas/complicaciones , Neoplasias Orofaríngeas/cirugía , Complicaciones Posoperatorias , Calidad de Vida , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Reino Unido/epidemiologíaRESUMEN
There are insufficient data on swallowing and the consequences of its dysfunction in patients with cancers of the oral cavity (OC) and oropharynx (OP) that are treated with primary surgery. The study attempts to explore the effect of important clinico-demographic variables on post-treatment swallowing and related quality of life (QOL) in post-surgical OC and OP cancer patients. Sixty-two consecutive OC and OP cancer patients completed the MD Anderson Dysphagia Inventory (MDADI) questionnaire. Mean scores were computed. Comparison of scores based on mean ranks were performed using Mann-Whitney U test or Kruskal-Wallis test. Level of significance was set at P ≤ 0.02. Adjustments were made for multiple comparisons. Significantly worse mean (SD) QOL scores were observed in late T-stage (T3/T4) versus early T-stage (T1/T2) patients for global domain, physical domain, functional domain and emotional domains [44.4 (21.9) vs. 78.7 (22.7) (P < 0.001); 50.0 (9.4) vs. 75.9 (16.3), (P < 0.0001); 57.8 (20.6) vs. 84.1 (16.7), (P < 0.001) and 55.2 (18.0) vs. 78.5 (16.3), (P < 0.001)], respectively. Patients undergoing reconstruction versus without reconstruction had worse QOL scores; 58.8 (26.9) versus 79.5 (22.8), (P < 0.01); 61.2 (15.1) versus 76.4 (17.5), (P = 0.002); 65.4 (20.5) versus 86.3 (15.9), (P < 0.0001) and 63.3 (18.8) versus 79.8 (16.3), (P < 0.01), respectively, for global, physical, functional and emotional domains. Advanced T-stage, reconstruction, younger age and base of tongue tumours have a negative impact on post-treatment swallow function and related QOL in these patients.
Asunto(s)
Deglución/fisiología , Neoplasias de la Boca/fisiopatología , Procedimientos Quirúrgicos Orales/métodos , Neoplasias Orofaríngeas/fisiopatología , Calidad de Vida , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/psicología , Neoplasias de la Boca/cirugía , Neoplasias Orofaríngeas/psicología , Neoplasias Orofaríngeas/cirugía , Encuestas y CuestionariosRESUMEN
The aim was to explore the impact of important clinico-demographic factors on the post-treatment quality of life (QOL) in surgically treated oral and oropharyngeal cancer patients. 63 consecutive follow-up oral and oropharyngeal cancer patients treated primarily with surgery were recruited. 55 patients sent the completed questionnaires and finally included in this study. QOL and important sub-domains of the QOL were assessed. Mean QOL scores (SD) were computed, level of significance was set at P < 0.05. The mean composite QOL score and standard deviation (SD) for oral and oropharyngeal cancer patients were 76.6 (15.2) and 73.4 (13.9), respectively. Patients with higher T-stage (T3 and T4) and higher overall-stage (III and IV) had lower mean QOL scores as against early T (T1 and T2) and overall early-stage (I and II); mean scores (SD) 64.3 (13.6) and 72.3 (13.8), and 76.6 (13.6) and 81.7 (14.1), respectively. Younger patients had lower mean scores (SD) than older patients; mean QOL scores (SD) 69.7 (14.0) and 79.6 (SD), respectively. Patients with reconstruction had lower mean QOL scores as compared to those without reconstruction; mean scores (SD) 67.6 (16.0) and 77.4 (12.5), respectively. In conclusion, tumor-stage, overall-stage, age of patients, and reconstruction had a significant direct effect on the post-treatment QOL of oral and oropharyngeal cancer patients.
Asunto(s)
Neoplasias de la Boca/psicología , Neoplasias de la Boca/cirugía , Neoplasias Orofaríngeas/psicología , Neoplasias Orofaríngeas/cirugía , Complicaciones Posoperatorias/psicología , Calidad de Vida/psicología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Quimioradioterapia Adyuvante/psicología , Terapia Combinada/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Estadificación de Neoplasias , Neoplasias Orofaríngeas/patología , Encuestas y CuestionariosRESUMEN
BACKGROUND: Although the concept of maintaining a period of 'nil by mouth' following head and neck reconstruction is commonly held ideas on delaying function have changed dramatically since the introduction of peri-operative care recovery programmes. This study sought to evaluate the outcomes of early feeding on patients undergoing free flap reconstruction of oral defects with particular emphasis on post-operative complications and length of stay. METHODS: Data was gathered prospectively on two cohorts of patients treated in a tertiary referral centre comparing those undergoing a five-day post-operative period of 'nil by mouth' with a second group in which the aim was to start fluids and soft diet on the day following surgery. Complications and length of stay were evaluated. RESULTS: Both early and late feeding groups comprised of 200 patients. No significant differences were observed in terms of age, gender, smoking and alcohol use or tumour T and N stages between the two groups. 8% of patients had complications at the recipient site but no difference was observed in the rates of flap dehiscence or fistula formation between the two groups. Early feeding was associated with a statistically reduced length of hospital stay (mean 11.6 days vs 20.6 days, p < 0.01). CONCLUSIONS: Early oral feeding following head and neck free flap reconstruction is not associated with an increase incidence of peri-operative complications but reduces hospital stay. The latter may have far-reaching implications for patients' physical and psychological well-being in addition to health care resources.
Asunto(s)
Nutrición Enteral/métodos , Neoplasias de Cabeza y Cuello/cirugía , Procedimientos de Cirugía Plástica/efectos adversos , Procedimientos de Cirugía Plástica/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
Although patients are commonly reviewed after primary treatment for squamous cell carcinoma (SCC) of the oral cavity, there is little evidence about the frequency and duration of such a review. To try and obtain further information about current practice within the United Kingdom we used a structured telephone questionnaire to contact 50 units. Most of them (n=40, 80%) had developed follow-up protocols, and 38 (76%) reviewed patients for 5 years. All units examined patients monthly for the first year, and 90% of patients were seen 2-monthly for the following year. Slight variations for follow-up existed in years 3 and 4, but by the fifth year, 6-monthly review was almost universal (96%). Despite this surprising concordance, few units implemented a risk-adapted follow-up protocol that was aimed at targeting those people likely to be cured of relapsing disease.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias de la Boca/cirugía , Procedimientos Quirúrgicos Orales , Evaluación de Resultado en la Atención de Salud/métodos , Pautas de la Práctica en Odontología , Protocolos Clínicos , Auditoría Odontológica , Estudios de Seguimiento , Humanos , Procedimientos de Cirugía Plástica , Encuestas y Cuestionarios , Reino UnidoAsunto(s)
Neoplasias de la Boca/cirugía , Procedimientos Quirúrgicos Orales/efectos adversos , Traumatismos del Nervio Craneal/etiología , Edema/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Rechazo de Injerto/etiología , Humanos , Hipertensión Intracraneal/etiología , Dolor Postoperatorio/etiología , Traumatismos de los Nervios Periféricos/etiología , Infección de la Herida Quirúrgica/etiologíaRESUMEN
BACKGROUND: Acoustic evaluation of speech is the least explored method of speech evaluation in patients with oral cavity and oropharyngeal cancer. The purpose of this study was to explore acoustic parameters of speech and their correlation with questionnaire evaluation and perceptual evaluation in patients with oral cavity and oropharyngeal cancer. METHODS: One hundred seventeen subjects (65 consecutive patients with oral cavity and oropharyngeal cancer and 52 controls) participated in this study. Formant frequencies (by Linear Predictive Coding), Speech Handicap Index, and London Speech Evaluation scale were used for acoustic evaluation, questionnaire evaluation, and perceptual evaluation, respectively. RESULTS: Men showed significant elevation in second formant (F2) values for patients with oral cavity cancer and those who underwent surgery alone. Female patients with early T classification cancers and those who underwent surgery and chemoradiation showed significant reduction in the mean F2 values. Importantly, however, acoustic evaluation parameters did not correlate with either perceptual evaluation or questionnaire evaluation parameters, although there was moderate correlation between questionnaire evaluation and perceptual evaluation speech parameters. CONCLUSION: Acoustic evaluation modalities have no clear role in the management of patients with oral cavity and oropharyngeal cancer.
Asunto(s)
Neoplasias de la Boca/cirugía , Neoplasias Orofaríngeas/cirugía , Acústica del Lenguaje , Trastornos del Habla/diagnóstico , Medición de la Producción del Habla/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/fisiopatología , Neoplasias Orofaríngeas/fisiopatología , Trastornos del Habla/etiología , Inteligibilidad del Habla , Encuestas y CuestionariosRESUMEN
The free fibular flap is commonly used for mandibular reconstruction because of its length, consistent blood supply, and relative ease of harvest. The bone has been shown to maintain mass over time, which confers a potential advantage over other osseous flaps. We know of no published papers on changes in height of fibular bone in patients treated for osteoradionecrosis (ORN). We measured the change in bony height over time as an indirect measure of bone mass. We identified 17 patients (mean age 65, range 49-80 years) who had had reconstruction with a free fibular flap for mandibular ORN. Of them, 10 had fixation with a reconstruction plate, and serial radiographs were available for inclusion in the study. Three measurements were taken on at least 2 rotational tomograms for each patient. Two observers recorded measurements at 25, 50, and 75% of the distance along the bone. Mean change in fibular height (mm) and percentage change were calculated. The interval between radiographs ranged from 5 months 4 days to 20 months 14 days. There was a reduction in fibular height in 8/10 cases, with a mean reduction of 1.5mm (range 2.6-0.3), or 11%. Our results show a moderate reduction in fibular height, which is comparable with a previously published series of patients without ORN who had reconstruction with miniplates. The stress shielding effects of reconstruction plates were less evident in our patients than in previously published material.
Asunto(s)
Resorción Ósea/diagnóstico por imagen , Trasplante Óseo/métodos , Peroné/diagnóstico por imagen , Colgajos Tisulares Libres/patología , Enfermedades Mandibulares/cirugía , Reconstrucción Mandibular/métodos , Osteorradionecrosis/cirugía , Anciano , Anciano de 80 o más Años , Placas Óseas , Tornillos Óseos , Peroné/trasplante , Estudios de Seguimiento , Colgajos Tisulares Libres/trasplante , Humanos , Reconstrucción Mandibular/instrumentación , Persona de Mediana Edad , Sistemas de Información Radiológica/instrumentación , Estudios Retrospectivos , Tomografía por Rayos X/métodosRESUMEN
Bell's palsy (idiopathic facial paralysis) is caused by the acute onset of lower motor neurone weakness of the facial nerve with no detectable cause. With a lifetime risk of 1 in 60 and an annual incidence of 11-40/100,000 population, the condition resolves completely in around 71% of untreated cases. In the remainder facial nerve function will be impaired in the long term. We summarise current published articles regarding early management strategies to maximise recovery of facial nerve function and minimise long-term sequelae in the condition.
Asunto(s)
Parálisis de Bell/terapia , Odontología Basada en la Evidencia , Medicina Basada en la Evidencia , Parálisis de Bell/tratamiento farmacológico , Nervio Facial/fisiología , Humanos , Recuperación de la Función/fisiología , Remisión EspontáneaRESUMEN
The aim of this article is to review the management of oral leukoplakia. The topics of interest are clinical diagnosis, methods of management and their outcome, factors associated with malignant transformation, prognosis, and clinical follow-up. Global prevalence is estimated to range from 0.5 to 3.4%. The point prevalence is estimated to be 2.6% (95% CI 1.72-2.74) with a reported rate of malignant transformation ranging from 0.13 to 17.5%. Incisional biopsy with scalpel and histopathological examination of the suspicious tissue is still the gold standard for diagnosis. A number of factors such as age, type of lesion, site and size, dysplasia, and DNA content have been associated with increased risk of malignant transformation, but no single reliable biomarker has been shown to be predictive. Various non-surgical and surgical treatments have been reported, but currently there is no consensus on the most appropriate one. Randomised controlled trials for non-surgical treatment show no evidence of effective prevention of malignant transformation and recurrence. Conventional surgery has its own limitations with respect to the size and site of the lesion but laser surgery has shown some encouraging results. There is no universal consensus on the duration or interval of follow-up of patients with the condition.
Asunto(s)
Leucoplasia Bucal/terapia , Transformación Celular Neoplásica/patología , Estudios de Seguimiento , Humanos , Leucoplasia Bucal/cirugía , Neoplasias de la Boca/prevención & control , Lesiones Precancerosas/cirugía , Lesiones Precancerosas/terapia , Factores de RiesgoRESUMEN
BACKGROUND: The aim of this study was to develop and validate the first ever speech-specific perceptual speech-evaluation tool for patients with head and neck cancer. METHODS: Five speech parameters (intelligibility, articulation, speech rate, nasality, and asthenia) and overall grade were included and evaluated. Speech samples of 117 subjects were recorded on electroglottograph equipment using a standard protocol and were independently judged and rated by 3 experienced speech and language therapists and re-rated 12 weeks apart. RESULTS: Among patients the Cronbach's alpha (α) coefficients for internal consistency for connected speech were 0.89, whereas for single words the α coefficients ranged between 0.80 and 0.84. The Spearman's correlation coefficients for intra-rater reliability for connected speech and words varied between 0.30 and 0.90 and 0.49 and 0.76, respectively, whereas for inter-rater reliability the coefficients ranged between 0.53 and 0.99 and 0.56 and 0.99, respectively. For construct validity, the Spearman's correlation coefficient ranged between 0.41 and 0.55. CONCLUSIONS: The London Speech Evaluation (LSE) scale demonstrated a high reliability and validity in our cohort of patients with head and neck cancer. surgery.
Asunto(s)
Neoplasias de Cabeza y Cuello/rehabilitación , Psicometría/instrumentación , Trastornos del Habla/diagnóstico , Inteligibilidad del Habla , Percepción del Habla , Adulto , Anciano , Femenino , Humanos , Londres , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Logopedia , Patología del Habla y Lenguaje/métodos , Encuestas y CuestionariosRESUMEN
The aim of this study was to explore post-treatment speech impairments using English version of Speech Handicap Index (SHI) (first speech-specific questionnaire) in a cohort of oral cavity (OC) and oropharyngeal (OP) cancer patients. Sixty-three consecutive OC and OP cancer patients in follow-up participated in this study. Descriptive analyses have been presented as percentages, while Mann-Whitney U-test and Kruskall-Wallis test have been used for the quantitative variables. Statistical Package for Social Science-15 statistical software (SPSS Inc., Chicago, IL) was used for the statistical analyses. Over a third (36.1%) of patients reported their speech as either average or bad. Speech intelligibility and articulation were the main speech concerns for 58.8% and 52.9% OC and 31.6% and 34.2% OP cancer patients, respectively. While feeling of incompetent and being less outgoing were the speech-related psychosocial concerns for 64.7% and 23.5% OC and 15.8% and 18.4% OP cancer patients, respectively. Worse speech outcomes were noted for oral tongue and base of tongue cancers vs. tonsillar cancers, mean (SD) values were 56.7 (31.3) and 52.0 (38.4) vs. 10.9 (14.8) (P<0.001) and late vs. early T stage cancers 65.0 (29.9) vs. 29.3 (32.7) (P<0.005). The English version of the SHI is a reliable, valid and useful tool for the evaluation of speech in HNC patients. Over one-third of OC and OP cancer patients reported speech problems in their day-do-day life. Advanced T-stage tumors affecting the oral tongue or base of tongue are particularly associated with poor speech outcomes.
Asunto(s)
Neoplasias de la Boca/complicaciones , Neoplasias Orofaríngeas/complicaciones , Trastornos del Habla/etiología , Inteligibilidad del Habla , Trastornos de la Articulación/epidemiología , Trastornos de la Articulación/etiología , Trastornos de la Articulación/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/terapia , Neoplasias Orofaríngeas/terapia , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Trastornos del Habla/epidemiología , Trastornos del Habla/psicología , Encuestas y Cuestionarios , Neoplasias de la Lengua/complicaciones , Neoplasias de la Lengua/terapia , Neoplasias Tonsilares/complicaciones , Neoplasias Tonsilares/terapia , Resultado del TratamientoRESUMEN
This final review in a series of three focuses on how the advances made in the realm of molecular and cellular bone biology have been translated into experimental animal and human surgery.
Asunto(s)
Huesos/fisiología , Ingeniería de Tejidos/métodos , Animales , Materiales Biomiméticos/química , Proteínas Morfogenéticas Óseas/fisiología , Huesos/cirugía , Humanos , Biología Molecular , Osteogénesis/fisiología , Medicina Regenerativa , Transducción de Señal/fisiología , Proteínas de la Superfamilia TGF-beta/fisiologíaRESUMEN
BACKGROUND: Posttreatment speech problems are seen in nearly half of patients with head and neck cancer. Although there are many voice-specific scales, surprisingly there is no speech-specific questionnaire for English-speaking patients with head and neck cancer. The aim of this study was to validate the Speech Handicap Index (SHI) as the first speech-specific questionnaire in the English language. METHOD: In all, 55 consecutive patients in follow-up for oral and oropharyngeal cancer completed the SHI and University of Washington Quality of Life Questionnaire (UWQOL V.04). Thirty-two patients completed both questionnaires again 4 weeks later to address test-retest reliability. RESULTS: Internal consistency, test-retest reliability, construct validity, and group validity of the SHI were found to be highly significant (p < .01) using Cronbach's alpha, Spearman's correlation coefficient (r), and Mann-Whitney U tests. CONCLUSIONS: The SHI is a precise, highly reliable, and valid speech assessment tool for patients with head and neck cancer. Further dedicated studies using the SHI in patients with head and neck cancer would be useful.
Asunto(s)
Evaluación de la Discapacidad , Neoplasias de Cabeza y Cuello/epidemiología , Calidad de Vida , Trastornos del Habla/diagnóstico , Trastornos del Habla/epidemiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Causalidad , Estudios de Cohortes , Comorbilidad , Personas con Discapacidad/rehabilitación , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/terapia , Humanos , Incidencia , Lenguaje , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/epidemiología , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Neoplasias Orofaríngeas/epidemiología , Neoplasias Orofaríngeas/patología , Neoplasias Orofaríngeas/terapia , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Distribución por Sexo , Trastornos del Habla/rehabilitación , Encuestas y CuestionariosRESUMEN
The radial forearm free flap (RFFF) is well-established in head and neck reconstruction, but early potential failure may necessitate a contingency plan, which could include the opposite RFFF if cannulation of the relevant artery at the time of the first operation did not influence its patency. We prospectively studied patients listed for major operations who required radial artery cannulation. They all had perioperative imaging of the radial artery with colour flow duplex before cannulation and at intervals after the cannula had been removed (2h-7 days). Forty patients were recruited (mean age 65 years, range 32-91). Thirty-three had patent vessels within 2h of the cannula being removed, and 39/40 at 24h. Patency after removal of the cannula returns rapidly, and is almost always complete by 24h. In most people the contralateral radial forearm could therefore be used to mode of salvage reconstruction if the flap failed early.
Asunto(s)
Colgajos Tisulares Libres/irrigación sanguínea , Arteria Radial/diagnóstico por imagen , Reperfusión/métodos , Ultrasonografía Doppler en Color , Grado de Desobstrucción Vascular/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Cateterismo Periférico/efectos adversos , Femenino , Antebrazo/irrigación sanguínea , Antebrazo/cirugía , Oclusión de Injerto Vascular/cirugía , Mano/irrigación sanguínea , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana Edad , Arteria Radial/cirugía , Procedimientos de Cirugía Plástica/métodos , Flujo Sanguíneo Regional , Recolección de Tejidos y ÓrganosRESUMEN
This review, the second in a series of three editorials, focuses on the problems of translating basic scientific research on induction of bone into reliable clinical applications.
Asunto(s)
Regeneración Ósea , Animales , Proteínas Morfogenéticas Óseas/farmacología , Regeneración Ósea/efectos de los fármacos , Regeneración Ósea/genética , Colágeno , Humanos , Músculo Esquelético , Proteínas Recombinantes/farmacología , Ingeniería de Tejidos , Andamios del Tejido , Factor de Crecimiento Transformador beta/farmacologíaRESUMEN
Secondary tumours of small intestine account for 10% of all small bowel cancers. The most common sites of primary tumour metastasizing to small bowel are uterus, cervix, colon, lung, breast and melanoma. The majority of these metastatic tumours come from adenocarcinoma primaries; squamous cell carcinoma constitutes a very small proportion of all metastatic small intestinal lesions. Metastasis to small bowel by head and neck squamous cell carcinoma is extremely rare and carries an unfavourable prognosis. Owing to the limited number of published studies, its characteristic features, clinical presentation and outcomes are poorly described. This work aims at specifying these characteristics by reviewing, compiling, analysing and reporting all published cases in the published literature on small bowel metastasis secondary to head and neck squamous cell carcinoma. To the best of our knowledge, this is the first comprehensive review article on the small intestinal metastasis from head and neck squamous cell carcinoma.
Asunto(s)
Carcinoma de Células Escamosas/secundario , Neoplasias de Cabeza y Cuello/patología , Neoplasias Intestinales/secundario , Intestino Delgado/patología , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/mortalidad , Neoplasias de Cabeza y Cuello/mortalidad , Humanos , Neoplasias Intestinales/mortalidad , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
Impairment of swallowing function is a common multidimensional symptom complex seen in 50-75% of head and neck cancer (HNC) survivors. Although there are a number of validated swallowing-specific questionnaires, much of their focus is on the evaluation of swallowing-related quality of life (QOL) rather than swallowing as a specific function. The aim of this study was to validate the Sydney Swallow Questionnaire (SSQ) as a swallowing-specific instrument in HNC patients. Fifty-four consecutive patients in follow-up for oral and oropharyngeal cancer completed the SSQ and MD Anderson Dysphagia Inventory (MDADI). Thirty-one patients completed both questionnaires again four weeks later to address test-retest reliability. Internal consistency and test-retest reliability was assessed using Cronbach's alpha and Spearman's correlation coefficient, respectively. Construct validity (including group validity) and criterion validity were determined using Spearman's correlation coefficient and Mann-Whitney U-test. Internal consistency, test-retest reliability, construct validity, group validity and criterion validity of the SSQ was found to be significant (P<0.01). We were able to demonstrate the reliability and validity of the SSQ in HNC patients. The SSQ is a precise, reliable and valid tool for assessing swallow in this patient group.
Asunto(s)
Carcinoma de Células Escamosas/fisiopatología , Trastornos de Deglución/fisiopatología , Neoplasias de Cabeza y Cuello/fisiopatología , Calidad de Vida , Encuestas y Cuestionarios , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/complicaciones , Trastornos de Deglución/etiología , Femenino , Neoplasias de Cabeza y Cuello/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Perfil de Impacto de EnfermedadRESUMEN
Although the route of invasion of oral squamous cell carcinoma into the intact mandible is well-documented we know of no reports about whether malignant cells invade through non-pathological fractures. A 68-year-old patient presented with a traumatic fracture of the mandible at the site of an existing carcinoma. He had asegmental resection but histological examination showed no evidence of invasion into the bone.
Asunto(s)
Carcinoma de Células Escamosas/patología , Fracturas Mandibulares/patología , Neoplasias de la Boca/patología , Anciano , Carcinoma de Células Escamosas/cirugía , Humanos , Masculino , Fracturas Mandibulares/cirugía , Suelo de la Boca/patología , Suelo de la Boca/cirugía , Neoplasias de la Boca/cirugía , Invasividad Neoplásica , Úlceras Bucales/patología , Úlceras Bucales/cirugía , Osteotomía/métodosRESUMEN
Although the anterolateral thigh flap (ALT) is used by many instead of the radial forearm free flap in the reconstruction of defects after hemiglossectomy, the shape of the patient's body invariably dictates the volume of tissue harvested. Here a chimeric vastus lateralis free flap is described as an alternative. For the surgeon familiar with the anatomical territory of the ALT, this may be a useful option in certain clinical circumstances.