title: Significant preservation of swallowing function in chemoradiotherapy for advanced head and neck cancer by prophylactic swallowing exercise.
abstract: BACKGROUND
  Dysphagia is a serious complication of chemoradiotherapy (CRT) in patients with head and neck cancer. Approximately 20% to 30% of patients who have dysphagia require feeding tubes. The purpose of this study was to evaluate the impact of prophylactic swallowing exercises on swallowing function.
  
  
  METHODS
  Fifty-one patients with advanced oropharyngeal, hypopharyngeal, and laryngeal cancers were included in this study. Twenty-one patients performed the Shaker exercise and 30 practiced traditional Mendelsohn maneuvers (control group). Before and after treatment, videofluoroscopy and swallowing motion were analyzed to establish movement of the hyoid bone, larynx, and aspiration scores.
  
  
  RESULTS
  Average movement of the hyoid bone, thyrohyoid shortening, and upper esophageal sphincter opening were significantly better maintained in the Shaker group. Aspiration score of the Shaker exercise was significantly lower than control group. Feeding tube rates for the Shaker and control groups were 14% and 40% (p < .05).
  
  
  CONCLUSIONS
  Shaker exercises as a prophylactic exercise contributed to preservation of swallowing function in patients with head and neck cancer.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ohba
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Junkichi
authors.initials: J
authors.lastname: Yokoyama
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kojima
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Fujimaki
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Anzai
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Komatsu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D059248:Chemoradiotherapy / Q000379:methods*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology / Q000517:prevention & control*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Shaker exercise; chemoradiotherapy; dysphagia; head and neck cancer; supportive care; swallowing exercise