title: Functional outcome assessment of swallowing (FOAMS) scoring and videofluoroscopic evaluation of perioperative swallowing rehabilitation in radical esophagectomy.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama, 930-0194, Japan. okumura@med.u-toyama.ac.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Okumura
authors.affiliation: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama, 930-0194, Japan.|Department of Nanobio Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida Shimoadachicho 46-29, Sakyo-ku, Kyoto, 606-8501, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Shimada
authors.affiliation: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama, 930-0194, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Oral and Maxillofacial Surgery, Toyama University Hospital, Sugitani 2630, Toyama, 930-0194, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Nakamichi
authors.affiliation: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama, 930-0194, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Nagata
authors.affiliation: Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Sugitani 2630, Toyama, 930-0194, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tsukada
mesh_terms: D000368:Aged; D003679:Deglutition; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D059035:Perioperative Period; D014741:Video Recording
keywords: Esophageal cancer; Esophagectomy; Perioperative swallowing rehabilitation; Videofluoroscopic evaluation