Risk factors for dysphagia in post-irradiated nasopharyngeal carcinoma patients – a physiological study
Refereed conference paper presented and published in conference proceedings


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AbstractPurpose: Nasopharyngeal cancer (NPC) is the most common head and neck cancer in Hong Kong. Patients treated with (chemo-)radiotherapy may develop long-term dysphagia, which may result in aspiration pneumonia. There is limited quantitative physiological data available to investigate risk factors for dysphagia in this population. The present study aimed at 1) establishing physiological data for irradiated NPC patients, and 2) examining how well these physiological parameters are in predicting the occurrence of dysphagia.
Methods: This was a cross-sectional study of 60 long-term NPC survivors (mean age: 57.8 years) previously treated by radiotherapy with/without chemotherapy. Radiotherapy had been completed for an average of 12.3 years. Videofluoroscopic study of swallowing (VFSS) was performed on thin and puree consistency. Dysphagia was defined as the presence of penetration or aspiration (i.e. PAS score≥3) on at least one consistency during the examination. Kinematic and temporal measurements were obtained from analyses of videofluoroscopic images. Analyses of variance were conducted for each biomechanical variable to test for differences between patients with and without dysphagia. A binary logistic regression analysis was performed to identify significant factors predictive of dysphagia.
Results: There was significant difference between the two groups (i.e. ‘dysphagia’ and ‘no dysphagia’) in anterior hyoid displacement (p=.004), oral transit time (p=.000), pharyngeal transit time (p=.000), pharyngeal delay time (p=.000), upper esophageal sphincter opening (p=.005), and pharyngeal constriction ratio (p=.000). Binary logistic regression analysis revealed that pharyngeal constriction ratio (odds ratio=1.2, p=.022) and pharyngeal delay time (odds ratio=26.8, p=.047) were associated with dysphagia.
Conclusion: The present study provided reference quantitative swallowing data in a cohort of irradiated NPC patients. In addition, physiological risk factors for dysphagia were identified. These factors should be considered when planning dysphagia treatment to this disease group. Further studies involving a larger sample size and more physiological parameters are under way.
All Author(s) ListCheng, D. T. H. , Lee, K. Y. S., Tong, M. C. F.
Name of Conference10th Asia Pacific Conference on Speech, Language and Hearing
Start Date of Conference17/09/2017
End Date of Conference19/09/2017
Place of ConferenceNarita
Country/Region of ConferenceJapan
Year2017
Month9
LanguagesEnglish-United States
KeywordsDysphagia, naso-pharyngeal carcinoma, aspiration, penetration, videofluoroscopy

Last updated on 2018-20-01 at 19:34