ABSTRACT
Abstract Introduction: Tongue cancer is one of the most common subtypes of head and neck cancer. The aggressive effects of treatment cause aesthetic, psychosocial and functional deficits, especially dysphagia, which affects patient quality of life. Rehabilitation, which is essential for functional maximum recovery, helps patients deal with new and altered structures and has a positive impact on quality of life. Objective: To verify the impact of speech therapy on swallowing quality of life in tongue cancer patients after treatment. Methods: This parallel randomized clinical trial was conducted at a public hospital in Porto Alegre, RS, Brazil. Before and after the intervention, a quality of life questionnaire (the Deglutition Handicap Index) was employed, dysphagia severity was assessed with fiberoptic endoscopic evaluation of swallowing, and the Functional Oral Intake Scale carried out. The experimental group underwent four-week sessions of speech therapy over one month, while the control group received the institution's usual follow-up. Results: Thirty individuals treated for tongue cancer were divided into a study and a control group. Deglutition Handicap Index scores decreased significantly (approximately 40 points) (p < 0.001) after the intervention in the study group. There was a significant correlation between improved quality of life, reduced dysphagia severity and increased in Functional Oral Intake Scale scores (p <0.001). Conclusion: After speech therapy, quality of life scores related to deglutition and dysphagia severity improved in patients treated for tongue cancer.
Resumo Introdução: O câncer de língua é um dos subtipos mais comuns do câncer de cabeça e pescoço. Os efeitos agressivos do tratamento causam impactos estéticos, psicossociais e funcionais, principalmente a disfagia, os quais afetam a qualidade devida do paciente. A reabilitação, essencial para a máxima recuperação funcional, auxilia o paciente a lidar com as novas estruturas e tem impacto positivo na qualidade de vida. Objetivo: Verificar o impacto da fonoterapia na Qualidade de Vida relacionada à deglutição de pacientes tratados por câncer de língua. Método: Ensaio clínico randomizado paralelo, realizado em um hospital público de Porto Alegre, RS, Brasil. Antes e após a intervenção, os participantes foram avaliados por meio de um questionário de Qualidade de Vida (o Índice de Desvantagem da Deglutição), classificados quanto a gravidade da disfagia (por meio do exame de Videoendoscopia da Deglutição) e quanto ao nível da escala funcional de ingestão por via oral. O grupo experimental foi submetido a quatro sessões semanais de fonoterapia no período de um mês, enquanto o grupo controle recebeu o acompanhamento habitual da instituição. Resultados: Trinta indivíduos tratados para câncer de língua foram divididos em um grupo estudo e um grupo controle. Houve uma diminuição significativa, de aproximadamente 40 pontos (p <0,001), nos escores de Qualidade de Vida após a intervenção no grupo experimental. Verificou-se correlação significativa entre a melhora da Qualidade de Vida, a redução da gravidade da disfagia e o aumento dos níveis da escala funcional de ingestão por via oral (p <0,001). Conclusão: Após a fonoterapia, pacientes tratados por câncer de língua apresentaram melhora nos escores de Qualidade de Vida relacionada à deglutição e na gravidade da disfagia.
ABSTRACT
INTRODUCTION: Tongue cancer is one of the most common subtypes of head and neck cancer. The aggressive effects of treatment cause aesthetic, psychosocial and functional deficits, especially dysphagia, which affects patient quality of life. Rehabilitation, which is essential for functional maximum recovery, helps patients deal with new and altered structures and has a positive impact on quality of life. OBJECTIVE: To verify the impact of speech therapy on swallowing quality of life in tongue cancer patients after treatment. METHODS: This parallel randomized clinical trial was conducted at a public hospital in Porto Alegre, RS, Brazil. Before and after the intervention, a quality of life questionnaire (the Deglutition Handicap Index) was employed, dysphagia severity was assessed with fiberoptic endoscopic evaluation of swallowing, and the Functional Oral Intake Scale carried out. The experimental group underwent four-week sessions of speech therapy over one month, while the control group received the institution's usual follow-up. RESULTS: Thirty individuals treated for tongue cancer were divided into a study and a control group. Deglutition Handicap Index scores decreased significantly (approximately 40 points) (pâ¯<â¯0.001) after the intervention in the study group. There was a significant correlation between improved quality of life, reduced dysphagia severity and increased in Functional Oral Intake Scale scores (pâ¯<â¯0.001). CONCLUSION: After speech therapy, quality of life scores related to deglutition and dysphagia severity improved in patients treated for tongue cancer.
Subject(s)
Deglutition Disorders , Tongue Neoplasms , Deglutition , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Humans , Quality of Life , Speech Therapy , Tongue , Tongue Neoplasms/complications , Tongue Neoplasms/therapy , Treatment OutcomeABSTRACT
PURPOSE: To describe and characterize a finding, i.e., delayed posterior leakage of food residue during swallowing, according to age, gender and food consistency, which occurred in the event. METHODS: Data were collected through the analysis of each functional videonasoendoscopy test of swallowing previously recorded in a specialist outpatient clinic. The study population included 200 patients, both males and females, aged between 46 and 87 years, with and without an underlying pathology for dysphagia. The images were studied individually by the researcher and analyzed by judges in order to identify and select images that would confirm the presence or absence of the study event. RESULTS: Delayed escape was found in 45 out of the 200 analyzed tests. The tests selected for the study showed delayed posterior bolus leakage in at least one consistency. The highest frequency of delayed posterior leakage occurred with fluids. The analysis showed the significance of the study event with the population related to older ages in the sample analyzed. CONCLUSION: Delayed posterior leakage occurs predominantly in the liquid consistency in older populations with no gender predominance.
OBJETIVO: Descrever e caracterizar um achado, o escape posterior tardio de resíduo alimentar na deglutição, segundo idade, gênero e consistência do alimento, que ocorreu no evento. MÉTODO: A coleta de dados ocorreu por meio da análise de cada exame de videonasoendoscopia funcional da deglutição anteriormente gravado em um ambulatório especializado. A população do estudo contemplou 200 pacientes de ambos os gêneros, na faixa etária entre 46 e 87 anos, com e sem patologia de base para disfagia. As imagens foram estudadas individualmente pelo pesquisador e analisadas por juízes, com o objetivo de identificar e selecionar imagens que constatassem a presença ou ausência do evento em estudo. RESULTADOS: Verificou-se o escape tardio em 45 exames do total de 200 analisados. Os exames selecionados para o estudo apresentaram o escape residual posterior tardio em pelo menos uma consistência. A maior frequência do escape posterior tardio ocorreu com o líquido. A análise mostrou significância do evento em estudo com a população que apresentava idades mais avançadas da nossa amostra. CONCLUSÃO: O escape posterior tardio ocorre predominantemente na consistência líquida, em população mais idosa e sem predomínio de gênero.
