title: Water swallow screening test for patients after surgery for head and neck cancer: early identification of dysphagia, aspiration and limitations of oral intake.
abstract: Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC.
authors.affiliation: Department of Phoniatrics and Pediatric Audiology, University of Frankfurt/Main, Theodor-Stern-Kai 7, House 7A, D-60590 Frankfurt/Main, Germany. Christiane.Hey@kgu.de.
authors.forename: Christiane
authors.initials: C
authors.lastname: Hey
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Lange
authors.forename: Silvia
authors.initials: S
authors.lastname: Eberle
authors.forename: Yevgen
authors.initials: Y
authors.lastname: Zaretsky
authors.forename: Robert
authors.initials: R
authors.lastname: Sader
authors.forename: Timo
authors.initials: T
authors.lastname: Stöver
authors.forename: Jens
authors.initials: J
authors.lastname: Wagenblast
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology; D004327:Drinking Behavior; D006258:Head and Neck Neoplasms / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D053120:Respiratory Aspiration / Q000175:diagnosis*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D014867:Water; D055815:Young Adult
chemical_list: D014867:Water
keywords: Dysphagia; head and neck cancer; postsurgical; screening; swallowing disorder