Current assessment and treatment strategies of dysphagia in head and neck cancer patients: a systematic review of the 2012/13 literature

• Published in: Current opinion in supportive & palliative care Vol. 8; no. 2; p. 152
• Main Authors: Kraaijenga, S A C, van der Molen, L, van den Brekel, M W M, Hilgers, F J M
• Format: Journal Article
• Language: English
• Published: United States 01.06.2014
• Subjects: Deglutition; Deglutition Disorders - etiology; Deglutition Disorders - psychology; Deglutition Disorders - rehabilitation; Exercise Therapy - methods; Head and Neck Neoplasms - complications; Head and Neck Neoplasms - psychology; Head and Neck Neoplasms - radiotherapy; Humans; Patient Care Team; Quality of Life
• ISSN: 1751-4266
• DOI: 10.1097/SPC.0000000000000050

Dysphagia, or swallowing impairment, is a serious sequel of head and neck cancer (HNC) and its treatment. This review focuses on the rapidly growing literature published during the past 2 years about the current assessment and treatment strategies of dysphagia in HNC patients. Functional swallowing assessment has become standard of care in many HNC centers, to prevent or identify (silent) aspiration, to optimize functional outcomes, and to determine the appropriate rehabilitation strategy. Also preventive swallowing exercises are considered more and more in the pretreatment setting with promising results on (pharyngeal) swallowing function. However, there is a lack of consensus regarding type, frequency, or intensity of the exercises. Furthermore, long-term follow-up of swallowing function might be necessary, given the potential for long-term sequels following HNC treatment. Regarding dysphagia evaluation, there is still a lack of a uniform 'gold-standard' for both assessment and treatment strategies. More high-quality data, adequately controlled, adequately powered and randomized, on prophylactic and therapeutic swallowing exercises are needed, with longer follow-up and better adherence to treatment, for better understanding the effects of chemo and radiotherapy dosage, and of frequency, timing and duration of treatment, to improve swallowing function and optimize quality of life.