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Functional Swallow-Related Outcomes Following Transoral Robotic Surgery for Base of Tongue Carcinoma

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Abstract

In an era where the incidence of oropharyngeal cancer is growing steadily, there have been few studies exploring functional outcomes for individuals whose definitive cancer management approach includes transoral robotic surgical (TORS) resection. This study was designed to examine swallow-related outcomes in individuals newly diagnosed with base of tongue cancer whose treatment plan included surgical resection via TORS. The aims of this study were to determine whether TORS resection for early stage BOT SCCA affected: (a) lingual strength, (b) swallow safety and efficiency, (c) oral intake, and (d) swallowing-related quality of life. Nine individuals meeting the inclusion criteria were recruited to participate from March 2017 to April 2018. Each participant was evaluated at four distinct time points: (a) preoperatively, (b) 1 week postoperatively, (c) 1 month postoperatively, and (d) 3 months postoperatively. The following data were collected at each time point: (a) maximum isometric lingual pressure, (b) Penetration-Aspiration Scale score, (c) Yale Pharyngeal Residue Severity Rating Scale scores, (d) Functional Oral Intake Scale score, and (e) EAT-10 score. Data analysis revealed that a significant decline in maximum isometric lingual pressure, EAT-10 scores, and Functional Oral Intake Scale scores occurred between preoperative baseline measurements and 1 week post surgery. All participants in the study demonstrated a return to levels at or near their baseline level of function for maximum isometric lingual pressure, EAT-10 score, and Functional Oral Intake Scale score by 1 or 3 months post surgery. There were no significant changes in swallow safety or efficiency observed at any time point during the study.

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References

  1. American Cancer Society. (2020). Cancer facts & figures 2020. Retrieved from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf

  2. Hutcheson K, Holsinger FC, Kupferman M, Lewin J. Functional outcomes after TORS for oropharyngeal cancer: a systematic review. Eur Arch Otorhinolaryngol. 2015;272(2):463–71. https://doi.org/10.1007/s00405-014-2985-7.

    Article  PubMed  Google Scholar 

  3. Hutcheson K, Lewin J. Functional outcomes after chemoradiotherapy of laryngeal and pharyngeal cancers. Curr Oncol Rep . 2012;14(2):158–65. https://doi.org/10.1007/s11912-012-0216-1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Langmore SE, Krisciunas GP. Dysphagia after radiotherapy for head and neck cancer: etiology, clinical presentation, and efficacy of current treatments. SIG 13 Perspect Swallow Swallow Disord (Dysph). 2010;19(2):32–8. https://doi.org/10.1044/sasd19.2.32.

    Article  Google Scholar 

  5. Moore EJ, Olsen KD, Kasperbauer JL. Transoral robotic surgery for oropharyngeal squamous cell carcinoma: a prospective study of feasibility and functional outcomes. The Laryngoscope. 2009;119(11):2156–64. https://doi.org/10.1002/lary.20647.

    Article  PubMed  Google Scholar 

  6. Sinclair CF, McColloch NL, Carroll WR, Rosenthal EL, Desmond RA, Magnuson J. Patient-perceived and objective functional outcomes following transoral robotic surgery for early oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2011;137(11):1112–6. https://doi.org/10.1001/archoto.2011.172.

    Article  PubMed  Google Scholar 

  7. Hurtuk A, Agrawal A, Old M, Teknos TN, Ozer E. Outcomes of transoral robotic surgery: a preliminary clinical experience. Otolaryngol Head Neck Surg. 2011;145(2):248–53. https://doi.org/10.1177/0194599811402172.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Leonhardt FD, Quon H, Abrahão M, O’Malley BW, Weinstein GS. Transoral robotic surgery for oropharyngeal carcinoma and its impact on patient-reported quality of life and function. Head Neck. 2012;34(2):146–54. https://doi.org/10.1002/hed.21688.

    Article  PubMed  Google Scholar 

  9. Iseli, T. A., Kulbersh, B. D., Iseli, C. E., Carroll, W. R., Rosenthal, E. L., & Magnuson, J. S. (2009). Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg, 141(2), 166–171. Retrieved from http://oto.sagepub.com/content/141/2/166.full.pdf

  10. Chen AM, Daly ME, Luu Q, Donald PJ, Farwell DG. Comparison of functional outcomes and quality of life between transoral surgery and definitive chemoradiotherapy for oropharyngeal cancer. Head Neck. 2015;37(3):381–5. https://doi.org/10.1002/hed.23610.

    Article  PubMed  Google Scholar 

  11. Pauloski BR, Rademaker AW, Logemann JA, Stein D, Beery Q, Newman L, MacCracken E, et al. Pretreatment swallowing function in patients with head and neck cancer. Head Neck. 2000;22(5):474–82. https://doi.org/10.1002/1097-0347(200008)22:5%3c474::AID-HED6%3e3.0.CO;2-I.

    Article  CAS  PubMed  Google Scholar 

  12. Patterson J, Wilson JA. The clinical value of dysphagia preassessment in the management of head and neck cancer patients. Curr Opin Otolaryngol Head Neck Surg. 2011;19(3):177–81. https://doi.org/10.1097/MOO.0b013e328345aeb0.

    Article  PubMed  Google Scholar 

  13. Speksnijder CM, van der Bilt A, van der Glas HW, Koole R, Merkx MA. Tongue function in patients treated for malignancies in tongue and/or floor of mouth: a one-year prospective study. Int J Oral Maxillofac Surg. 2011;40(12):1388–94. https://doi.org/10.1016/j.ijom.2011.09.003.

    Article  CAS  PubMed  Google Scholar 

  14. IOPI Medical (2013a). Iowa oral performance instrument (Version 2.3) [Measurement device]. Redmond, WA: IOPI Medical.

  15. Robin DA, Goel A, Somodi LB, Luschei ES. Tongue strength and endurance: relation to highly skilled movements. J Speech Lang Hear Res. 1992;35(6):1239–45. https://doi.org/10.1044/jshr.B5061239.

    Article  CAS  Google Scholar 

  16. Medical IOPI. IOPI user manual. Redmond, WA: IOPI Medical; 2013.

    Google Scholar 

  17. Milner-Brown HS, Miller R. Muscle membrane excitation and impulse propagation velocity are reduced during muscle fatigue. Muscle Nerve. 1986;9(4):367–74. https://doi.org/10.1002/mus.880090415.

    Article  CAS  PubMed  Google Scholar 

  18. Acteon North America (2016). Sopro Medical Imaging Software (Version 2.20) [Computer software]. Mt. Laurel, NJ: Acteon North America.

  19. Langmore SE, Aviv JE. Endoscopic procedures to evaluate oropharyngeal swallowing. In: Langmore SE, editor. Endoscopic evaluation and treatment of swallowing disorders. New York: Thieme; 2001.

    Google Scholar 

  20. Langmore S, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia. 1988;2(4):216–9. https://doi.org/10.1007/BF02414429.

    Article  CAS  PubMed  Google Scholar 

  21. Hapner ER. Training and interpretation of FEES in adults. San Diego, CA: Plural Publishing; 2010.

    Google Scholar 

  22. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8. https://doi.org/10.1007/BF00417897.

    Article  CAS  PubMed  Google Scholar 

  23. Neubauer PD, Rademaker AW, Leder SB. The yale pharyngeal residue severity rating scale: an anatomically defined and image-based tool. Dysphagia. 2015;30(5):521–8. https://doi.org/10.1007/s00455-015-9631-4.

    Article  PubMed  Google Scholar 

  24. Crary MA, Carnaby-Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86(8):1516–20. https://doi.org/10.1016/j.apmr.2004.11.049.

    Article  PubMed  Google Scholar 

  25. Belafsky, P. C., Mouadeb, D. A., Rees, C. J., Pryor, J. C., Postma, G. N., Allen, J., & Leonard, R. J. (2008). Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol, 117(12), 919–924. Retrieved from http://oto.sagepub.com/content/147/1/40.long

  26. IBM. SPSS Statistics (Version 23) [Computer software]. Armonk, NY: International Business Machines Corporation; 2016.

    Google Scholar 

  27. Weinstein GS, O’Malley BW Jr, Snyder W, Sherman E, Quon H. Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg. 2007;133(12):1220–6. https://doi.org/10.1001/archotol.133.12.1220.

    Article  PubMed  Google Scholar 

  28. Lazarus CL, Ganz C, Ru M, Miles BA, Kotz T, Chai RL. Prospective instrumental evaluation of swallowing, tongue function, and QOL measures following transoral robotic surgery alone without adjuvant therapy. Head Neck. 2019;41(2):322–8.

    PubMed  Google Scholar 

  29. Genden EM, Park R, Smith C, Kotz T. The role of reconstruction for transoral robotic pharyngectomy and concomitant neck dissection. Arch Otolaryngol Head Neck Surg. 2011;137(2):151–6.

    Article  Google Scholar 

  30. Creswell JW. Educational research: planning, conducting, and evaluating quantitative and qualitative research. 5th ed. Boston, MA: Pearson Education; 2015.

    Google Scholar 

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Author information

Author notes

  1. Benjamin E. Leiby

    Present address: Thomas Jefferson University Hospital, 111 S. 11th Street, Philadelphia, PA, 19107, USA

Authors and Affiliations

  1. Department of Speech-Language Pathology, Salus University, 8360 Old York Rd, Elkins Park, PA, 19027, USA

    Kelly M. Salmon

  2. Department of Communication Sciences & Disorders, La Salle University, St. Benilde Tower #2213, 1900 W. Olney Av, Philadelphia, PA, 19141, USA

    Cesar Ruiz

  3. Department of Otolaryngology – Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut Street, 6th Floor, Philadelphia, PA, 19107, USA

    David M. Cognetti, Joseph M. Curry & Adam J. Luginbuhl

  4. Department of Radiation Oncology, Thomas Jefferson University Hospital, 111 South 11th Street, Suite G-301, Bodine Center, Philadelphia, PA, 19107, USA

    Voichita Bar-Ad

  5. Division of Biostatistics, Thomas Jefferson University, 1015 Chestnut Street, Suite 520, Philadelphia, PA, 19107, USA

    Benjamin E. Leiby

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Salmon, K.M., Ruiz, C., Cognetti, D.M. et al. Functional Swallow-Related Outcomes Following Transoral Robotic Surgery for Base of Tongue Carcinoma. Dysphagia 37, 28–36 (2022). https://doi.org/10.1007/s00455-021-10246-y

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