title: Efficacy of thickened liquids for eliminating aspiration in head and neck cancer: a systematic review.
abstract: OBJECTIVE
  To appraise the current videofluoroscopic evidence on the reduction of aspiration using thickened liquids in the head and neck cancer population.
  
  
  METHODS
  Search terms relating to deglutition or dysphagia or swallow and neoplasms and oncology or head and neck cancer and viscosity or texture and apira or residu* were combined with honey or nectar, xerostomia, and respiratory aspiration using Boolean operators.
  
  
  METHODS
  A multiengine literature search identified 337 nonduplicate articles, of which 6 were judged to be relevant. These underwent detailed review for study quality and qualitative synthesis.
  
  
  RESULTS
  The articles reviewed in detail predominantly described heterogeneous study samples with small sample sizes, making for difficult interpretation and generalization of results. Rates of aspiration were typically not reported by bolus consistency, despite the fact that a variety of stimulus consistencies was used during a videofluoroscopic swallowing study. Studies confirmed that aspiration is a major concern in the head and neck cancer population and reported a trend toward more frequent aspiration after (chemo)radiotherapy.
  
  
  CONCLUSIONS
  Overall, the literature on thickened liquids as an intervention to eliminate aspiration in the head and neck cancer population is limited. Because aspiration is known to be prevalent in the head and neck cancer population and thickened liquids are known to eliminate aspiration in other populations, it is important to determine the effectiveness of thickened liquids for reducing aspiration in the head and neck cancer population.
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada carly.barbon@uhn.ca.
authors.forename: Carly E A
authors.initials: CE
authors.lastname: Barbon
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada Institute for Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada Bloorview Research Institute, Toronto, Ontario, Canada.
authors.forename: Catriona M
authors.initials: CM
authors.lastname: Steele
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology*; D004750:Enteral Nutrition / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D053120:Respiratory Aspiration / Q000517:prevention & control*; D014741:Video Recording; D014783:Viscosity
keywords: aspiration; deglutition; deglutition disorders; dysphagia; head and neck cancer; pneumonia; thickened liquid