Functional outcome assessment of swallowing (FOAMS) scoring and videofluoroscopic evaluation of perioperative swallowing rehabilitation in radical esophagectomy

• Published in: Surgery today (Tokyo, Japan) Vol. 46; no. 5; pp. 543 - 551
• Main Authors: Okumura, Tomoyuki, Shimada, Yutaka, Watanabe, Toru, Nakamichi, Naomi, Nagata, Takuya, Tsukada, Kazuhiro
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.05.2016
• Subjects: Aged; Deglutition; Esophageal Neoplasms - physiopathology; Esophageal Neoplasms - rehabilitation; Esophageal Neoplasms - surgery; Esophagectomy - methods; Female; Fluoroscopy; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Outcome Assessment; Perioperative Period; Surgery; Surgical Oncology; Esophagectomy; Videofluoroscopic evaluation; Perioperative swallowing rehabilitation; Esophageal cancer
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-015-1203-6

Purpose Oropharyngeal swallowing dysfunction following esophagectomy has been associated with the surgical disruption of muscle strength and flexibility of the oropharyngeal structures. We assessed the value of perioperative swallowing rehabilitation (SR) in patients who underwent radical esophagectomy. Methods We instituted routine perioperative SR for patients with esophageal cancer and retrospectively compared postoperative swallowing function between the patients who received ( n  = 12) vs. those who did not receive ( n  = 14) SR. Results The average duration of pre- and postoperative SR was 23.0 and 26.0 days, respectively. Preoperatively, the functional outcome assessment of the swallowing (FOAMS) score was 7 (full marks) in all 26 patients, whereas the average score at hospital discharge was 6.3 vs. 5.5 in the patients who received vs. those who did not receive SR, respectively ( p  = 0.049). Videofluoroscopic examination ( n  = 12) demonstrated that the maximum superior excursion of hyoid bone increased significantly with preoperative SR ( p  = 0.030), as well as postoperative SR ( p  = 0.046). However, perioperative SR did not reduce the incidence of postoperative aspiration pneumonia or the duration of hospital stay. Conclusions Swallowing function after radical esophagectomy was improved by perioperative SR; however, further investigations are needed to assess the clinical significance of SR in reducing surgical complications.