Validity of a dysphagia screening test following resection for head and neck cancer
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ORIGINAL ARTICLE
Validity of a dysphagia screening test following resection for head and neck cancer Nobuhide Horii 1 & Yoko Hasegawa 1,2 & Ayumi Sakuramoto-Sadakane 1 & Shyota Saito 3 & Tomoki Nanto 3 & Yuta Nakao 3 & Kazuhisa Domen 4 & Takahiro Ono 2 & Hiromitsu Kishimoto 1 Received: 2 April 2020 / Accepted: 18 June 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background The aim of this study was to evaluate the validity of a dysphagia screening test (DST) in patients who have undergone resection for head and neck cancer (HNC). In addition, we examined whether or not combined effects of DSTs improve the detection accuracy of penetration/aspiration. Methods Thirty-six HNC patients were participated. The DST consisted of the repetitive saliva swallowing test (RSST), the water swallowing test (WST), the modified water swallowing test (MWST), the food test (FT), and tongue pressure. A videofluoroscopic swallowing study was conducted, and the penetration–aspiration scale was used for scoring. For statistical analyses, we used the receiver operating characteristic (ROC) analysis. Furthermore, the accuracy of the determination of penetration/aspiration was evaluated by combining two or three DSTs. Results The penetration/aspiration could be predicted with moderate accuracy based on MWST and FT. The area under the ROC curve (AUC) values of the MWST and FT were 0.76 (p = 0.03) and 0.80 (p = 0.050), and the sensitivity/specificity was 0.9/0.61 (MWST) and 0.8/0.8 (FT), respectively. As a result of combining 2 or 3 DSTs, the combination of “MWST and FT” was the most accurate, with an AUC of 0.87 (p = 0.02). The combination of three tests had lower accuracy than the combination of two tests. Conclusion Based on our results, it is recommended that MWST or FT be used when only one type of DST is performed. In addition, the combination of two DSTs may detect aspiration patients more accurately than one alone. Keywords Deglutition . Dysphagia . Head and neck cancer . Screening test . Videofluoroscopic swallowing study
Introduction
Nobuhide Horii and Yoko Hasegawa contributed equally to this work. * Yoko Hasegawa [email protected] 1
Department of Dentistry and Oral Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya city, Hyogo 663-8501, Japan
2
Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 5274, Gakkocho-dori 2-bancho, Chuo-ku, Niigata city 951-8514, Niigata, Japan
3
Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Hyogo, Japan
4
Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
It is common for head and neck cancer (HNC) patients to experience dysphagia following surgical resection [1, 2]. Dysphagia after the surgical resection of HNC may result in aspiration (causing pneumonia and chronic lung disease) [3] and interrupt the postoperative recovery. Ingestion/swallowing dysfunction delays the resumpti
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