RESUMO
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.
Assuntos
Transtornos de Deglutição/fisiopatologia , Deglutição/fisiologia , Neoplasias Orofaríngeas/fisiopatologia , Inquéritos e Questionários , Estudos Transversais , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/complicações , Neoplasias Orofaríngeas/cirurgia , Complicações Pós-Operatórias , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do Tratamento , Reino Unido/epidemiologiaRESUMO
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.
Assuntos
Deglutição/fisiologia , Neoplasias Bucais/fisiopatologia , Procedimentos Cirúrgicos Bucais/métodos , Neoplasias Orofaríngeas/fisiopatologia , Qualidade de Vida , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/psicologia , Neoplasias Bucais/cirurgia , Neoplasias Orofaríngeas/psicologia , Neoplasias Orofaríngeas/cirurgia , Inquéritos e QuestionáriosRESUMO
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.
Assuntos
Neoplasias Bucais/psicologia , Neoplasias Bucais/cirurgia , Neoplasias Orofaríngeas/psicologia , Neoplasias Orofaríngeas/cirurgia , Complicações Pós-Operatórias/psicologia , Qualidade de Vida/psicologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia Adjuvante/psicologia , Terapia Combinada/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Inquéritos e QuestionáriosRESUMO
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.
Assuntos
Neoplasias Bucais/cirurgia , Neoplasias Orofaríngeas/cirurgia , Acústica da Fala , Distúrbios da Fala/diagnóstico , Medida da Produção da Fala/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/fisiopatologia , Neoplasias Orofaríngeas/fisiopatologia , Distúrbios da Fala/etiologia , Inteligibilidade da Fala , Inquéritos e QuestionáriosRESUMO
Primary liposarcoma of the thyroid gland is extremely rare with only two previous reports in the literature. We report two further cases, both patients presenting with rapid airways compression. Patient 1 had clinical, radiographic, and biopsy appearances suggesting benign goiter. Patient 2 had a long-term history of benign goiter, a previous partial thyroidectomy, and more recent biopsies showing liposarcoma. The management of such rare conditions is always challenging.
Assuntos
Bócio/diagnóstico , Lipossarcoma/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Idoso , Evolução Fatal , Feminino , Humanos , Lipossarcoma/complicações , Lipossarcoma/cirurgia , Lipossarcoma Mixoide/diagnóstico , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/cirurgia , Doenças da Traqueia/etiologiaRESUMO
c-erbB receptor signalling induces pleiotropic responses and influences several biological functions involved in the pathogenesis and progression of HNSCC. Aberrant expression of multiple c-erbB receptors and ligands is frequently observed in tumour cells. EGFR appears to be a dominant factor controlling the malignant phenotype in HNSCC at least in part via regulation of molecules involved in invasive and angio-/lymphangiogenic processes. Although c-erbB-2 is an orphan receptor, the formation of heterodimer complexes appears to be an important mechanism for inter-receptor activation and synergistic signal transduction. The roles of c-erbB-3 and c-erbB-4 in HNSCC progression are less clear. However, their ability to form heterodimers with other c-erbB family members enhances proliferation and invasion in HNSCC cells. At least two major downstream signalling pathways, MAPK and PI3K, are involved in the transcriptional regulation of proteases and cytokines implicated in invasion and angiogenesis. Studies using clinical specimens confirmed experimental data that co-operative signalling of c-erbB receptors may play a significant role in the pathogenesis of HNSCC. Most therapeutic studies in HNSCC so far have focused on the strategies targeting of EGFR. Due to the complexity of the system both at the receptor and ligand levels and the integrated biological functions of the c-erbB family in HNSCC, the effect of combined c-erbB blockade (or their downstream signalling pathways) on HNSCC progression should be explored.
Assuntos
Carcinoma de Células Escamosas/enzimologia , Neoplasias de Cabeça e Pescoço/enzimologia , Proteínas de Neoplasias/metabolismo , Receptores Proteína Tirosina Quinases/metabolismo , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/secundário , Divisão Celular , Movimento Celular , Receptores ErbB/metabolismo , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Ligantes , Invasividade Neoplásica , Receptor ErbB-2/metabolismo , Receptor ErbB-3/metabolismo , Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismoRESUMO
We undertook a service evaluation to establish how oropharyngeal dysphagia is managed in head and neck cancer patients receiving radiotherapy in the United Kingdom. A web-based survey including 23 open and closed questions was distributed to Speech and Language Therapy (SLT) teams via a national network of Royal College of Speech and Language Therapists (RCSLT) special interest groups with members involved in head and neck cancer care. Forty-six teams responded to the survey and 89% completed the questionnaire fully. Fifty percent (n=21/42) of the SLT teams reported routinely seeing patients prior to commencing radiotherapy. Baseline oromotor assessment (85.7% (n=36/42)), clinical dysphagia assessment (90.5% (n=38/42)) and information provision on the potential treatment effects on swallowing (97.6% (n=41/42)) and communication ability (85.7% (n=36/42)) were the most common components of initial evaluation. In keeping with expert opinion and emerging evidence, prophylactic swallowing exercises were administered by 71.4% (n=30/42) of teams targeting specific aspects of swallowing, although the nature, intensity and duration of programmes varied. A range of measures are used to monitor progress during treatment. Our survey highlighted that resource limitations affect service provision with some teams managing the consequences of treatment rather than proactive multidisciplinary intervention prior to and during treatment. Cancer- and treatment-related dysphagia can impact significantly on a broad range of outcomes following radiotherapy. There is variability in dysphagia service provision to patients before, during and following treatment. Comprehensive evaluation of swallowing function prior to treatment and proactive management can yield benefits for patients, inform multidisciplinary case management and support those involved in clinical trials to accurately determine treatment effects.
Assuntos
Transtornos de Deglutição/reabilitação , Neoplasias de Cabeça e Pescoço/radioterapia , Lesões por Radiação/reabilitação , Transtornos de Deglutição/etiologia , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Internet , Lesões por Radiação/etiologia , Inquéritos e Questionários , Reino UnidoRESUMO
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.
Assuntos
Neoplasias de Cabeça e Pescoço/reabilitação , Psicometria/instrumentação , Distúrbios da Fala/diagnóstico , Inteligibilidade da Fala , Percepção da Fala , Adulto , Idoso , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fonoterapia , Patologia da Fala e Linguagem/métodos , Inquéritos e QuestionáriosRESUMO
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.
Assuntos
Neoplasias Bucais/complicações , Neoplasias Orofaríngeas/complicações , Distúrbios da Fala/etiologia , Inteligibilidade da Fala , Transtornos da Articulação/epidemiologia , Transtornos da Articulação/etiologia , Transtornos da Articulação/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Neoplasias Orofaríngeas/terapia , Estudos Retrospectivos , Índice de Gravidade de Doença , Distúrbios da Fala/epidemiologia , Distúrbios da Fala/psicologia , Inquéritos e Questionários , Neoplasias da Língua/complicações , Neoplasias da Língua/terapia , Neoplasias Tonsilares/complicações , Neoplasias Tonsilares/terapia , Resultado do TratamentoRESUMO
BACKGROUND: The pattern of distribution of cervical nodal involvement from primary parotid carcinomas has not been extensively described. METHODS: All cases of parotid carcinoma over a 10-year period treated at our institution were reviewed. Data from the patients with cervical metastases were analyzed. These findings were pooled with previously published data on topography of cervical lymph nodes from parotid carcinomas. RESULTS: Of 80 cases, 15 had cervical metastases (N+) in our series. When pooled with the data from all other reports, a total of 66 N+ cases were available for analysis. Twenty-eight percent of cases had involvement of level I, 59% had level II, 52% had level III, 38% had level IV, and 41% had level V. There were frequent skip metastases to level V but all were ipsilateral. CONCLUSION: The diffuse distribution of cervical nodal metastases does not support a high echelon neck dissection or radiotherapy fields limited to the upper chain in the management of cervical nodal disease.
Assuntos
Linfonodos/patologia , Neoplasias Parotídeas/patologia , Idoso , Feminino , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , PescoçoRESUMO
BACKGROUND: Pharyngeal diverticulum or Zenker's diverticulum carcinoma is a rare malignancy with a poor prognosis. Carcinoma arising in a recurrent pharyngeal diverticulum is even rarer, with only 1 such case reported in the English-language literature. We report 2 patients with pharyngeal diverticulum carcinoma exhibiting an unusual presentation and good long-term, disease-free survival with normal speech and swallowing. METHODS: A 70-year-old man with a carcinoma in a recurrent pharyngeal diverticulum excised 20 years previously and a 65-year-old man with a neck mass as the only presentation of pharyngeal diverticulum carcinoma. RESULTS: Our patients were treated with open resection, laryngeal preservation, and postoperative radiotherapy (PORT), resulting in long-term tumor control and disease-free survival of 5 and 15 years (longest reported), respectively. CONCLUSION: One-stage diverticulectomy with or without radiotherapy is the treatment of choice and can provide long-term control and survival.
Assuntos
Divertículo/patologia , Neoplasias Faríngeas/patologia , Lesões Pré-Cancerosas/patologia , Idoso , Biópsia por Agulha , Carcinoma/patologia , Carcinoma/radioterapia , Carcinoma/cirurgia , Carcinoma de Células Escamosas , Divertículo/cirurgia , Seguimentos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Estadiamento de Neoplasias , Neoplasias de Células Escamosas/patologia , Neoplasias de Células Escamosas/radioterapia , Neoplasias de Células Escamosas/cirurgia , Doenças Faríngeas/patologia , Doenças Faríngeas/cirurgia , Neoplasias Faríngeas/radioterapia , Neoplasias Faríngeas/cirurgia , Faringectomia/métodos , Radioterapia Adjuvante , Carcinoma de Células Escamosas de Cabeça e Pescoço , Resultado do TratamentoRESUMO
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.
Assuntos
Avaliação da Deficiência , Neoplasias de Cabeça e Pescoço/epidemiologia , Qualidade de Vida , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Causalidade , Estudos de Coortes , Comorbidade , Pessoas com Deficiência/reabilitação , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Incidência , Idioma , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/patologia , Neoplasias Bucais/terapia , Neoplasias Orofaríngeas/epidemiologia , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/terapia , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Distribuição por Sexo , Distúrbios da Fala/reabilitação , Inquéritos e QuestionáriosRESUMO
PURPOSE: A systematic review to establish what evidence is available for swallowing outcomes following IMRT for head and neck cancer. METHODS: Online electronic databases were searched to identify papers published in English from January 1998 to December 2009. Papers were independently appraised by two reviewers for methodological quality, method of swallowing evaluation and categorized according to the World Health Organisation's International Classification of Health Functions. The impact of radiation dose to dysphagia aspiration risk structures (DARS) was also evaluated. RESULTS: Sixteen papers met the inclusion criteria. The literature suggests that limiting the radiation dose to certain structures may result in favourable swallowing outcomes. Methodological limitations included variable assessment methods and outcome measures and heterogeneity of patients. There are only limited prospective data, especially where pre-treatment measures have been taken and compared to serial post-treatment assessment. CONCLUSIONS: Few studies have investigated the impact of IMRT on swallow function and the impact on everyday life. Initial studies have reported potential benefits but are limited in terms of study design and outcome data. Further well designed, prospective, longitudinal swallowing studies including multidimensional evaluation methods are required to enable a more comprehensive understanding of dysphagia complications and inform pre-treatment counselling and rehabilitation planning.
Assuntos
Carcinoma de Células Escamosas/radioterapia , Transtornos de Deglutição/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Carcinoma de Células Escamosas/psicologia , Transtornos de Deglutição/psicologia , Feminino , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Qualidade de Vida/psicologia , Lesões por Radiação/complicações , Dosagem Radioterapêutica/normas , Planejamento da Radioterapia Assistida por Computador , Resultado do TratamentoRESUMO
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.
Assuntos
Carcinoma de Células Escamosas/secundário , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias Intestinais/secundário , Intestino Delgado/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Neoplasias Intestinais/mortalidade , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
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.
Assuntos
Carcinoma de Células Escamosas/fisiopatologia , Transtornos de Deglutição/fisiopatologia , Neoplasias de Cabeça e Pescoço/fisiopatologia , Qualidade de Vida , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/complicações , Transtornos de Deglutição/etiologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Perfil de Impacto da DoençaRESUMO
Adequate visualization, appropriate equipment, a cooperative patient, and a skilled physician are keys to successful foreign body removal. The first attempt at removal is critical because success rates markedly decrease after the first failed attempt.
Assuntos
Meato Acústico Externo , Corpos Estranhos/terapia , Instrumentos Cirúrgicos , Desenho de Equipamento , HumanosRESUMO
Oral and oropharyngeal cancers are amongst the commonest cancers worldwide and present a major health problem. Owing to their critical anatomical location and complex physiologic functions, the treatment of oral and oropharyngeal cancers often affects important functions, including speech. The importance of speech in a patient's life can not be overemphasized, as its loss is often associated with severe functional and psychosocial problems and a poor quality of life. A thorough understanding of the speech problems that are faced by these patients and their timely management is the key to providing a better functional quality of life, which must be one of the major goals of modern oncologic practice. This review summarises key methods of evaluation and outcome of speech functions in the literature on oral and oropharyngeal cancer published between January 2000 and December 2008. Speech has been generally overlooked and poorly investigated in this group of patients. This review is an attempt to fill this gap by conducting the first speech-specific review for oral and oropharyngeal cancer patients. We have proposed guidelines for better understanding and management of speech problems faced by these patients in their day-to-day life.