Limits...
Analysis of Dysphagia Patterns Using a Modified Barium Swallowing Test Following Treatment of Head and Neck Cancer.

Lee SY, Kim BH, Park YH - Yonsei Med. J. (2015)

Bottom Line: The MBS results were rated on the 8-point penetration-aspiration scale (PAS) and swallowing performance status (SPS) score.Reduced base of the tongue (BOT) retraction (64.9%), reduced laryngeal elevation (57.9%), and cricopharyngeus (CP) dysfunction (47.4%) were found.Forty-one patients had a SPS score of more than 3, 25 patients had a score greater than 5, and 13 patients had a SPS score of more than 7.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology Head and Neck Surgery, CHA University, Bundang Medical Center, Seongnam, Korea.

ABSTRACT

Purpose: The purposes of this study were to evaluate specific dysphagia patterns and to identify the factors affecting dysphagia, especially aspiration, following treatment of head and neck cancer.

Materials and methods: A retrospective analysis of 57 patients was performed. Dysphagia was evaluated using a modified barium swallow (MBS) test. The MBS results were rated on the 8-point penetration-aspiration scale (PAS) and swallowing performance status (SPS) score.

Results: Reduced base of the tongue (BOT) retraction (64.9%), reduced laryngeal elevation (57.9%), and cricopharyngeus (CP) dysfunction (47.4%) were found. Reduced BOT retraction was correlated with clinical stage (p=0.011) and treatment modality (p=0.001). Aspiration in 42.1% and penetration in 33.3% of patients were observed. Twenty-four patients had PAS values over 6, implying aspiration. Forty-one patients had a SPS score of more than 3, 25 patients had a score greater than 5, and 13 patients had a SPS score of more than 7. Aspiration was found more often in patients with penetration (p=0.002) and in older patients (p=0.026). In older patients, abnormal swallowing caused aspiration even in those with a SPS score of more than 3, irrespective of stage or treatment, contrary to younger patients. Tube feeders (n=20) exhibited older age (65.0%), dysphagia/aspiration related structures (DARS) primaries (75.0%), higher stage disease (66.7%), and a history of radiotherapy (68.8%).

Conclusion: Reduced BOT retraction was the most common dysphagia pattern and was correlated with clinical stage and treatment regimens including radiotherapy. Aspiration was more frequent in patients who had penetration and in older patients. In contrast to younger patients, older patients showed greater risk of aspiration even with a single abnormal swallowing irrespective of stage or treatment.

Show MeSH

Related in: MedlinePlus

Penetration-aspiration scale (PAS) and swallowing performance score (SPS) determined via MBS. Twenty-four (42%) patients had a PAS score over 6, implying aspiration. Patients with a SPS score over 5 are at risk of aspiration and those with a score of 7 absolutely require primary tube feeding. Twenty-five (43.9%) patients had a score over 5 and 13 patients had a score of 7. MBS, modified barium swallow.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4541650&req=5

Figure 1: Penetration-aspiration scale (PAS) and swallowing performance score (SPS) determined via MBS. Twenty-four (42%) patients had a PAS score over 6, implying aspiration. Patients with a SPS score over 5 are at risk of aspiration and those with a score of 7 absolutely require primary tube feeding. Twenty-five (43.9%) patients had a score over 5 and 13 patients had a score of 7. MBS, modified barium swallow.

Mentions: The distributions of PAS and SPS values are shown in Fig. 1. Twenty-four (42%) patients had PAS values over 6, implying aspiration. Forty-one (71.9%) patients had a score of more than 3; 25 (43.9%) patients had a score greater than 5; and 13 patients had a SPS score of more than 7.


Analysis of Dysphagia Patterns Using a Modified Barium Swallowing Test Following Treatment of Head and Neck Cancer.

Lee SY, Kim BH, Park YH - Yonsei Med. J. (2015)

Penetration-aspiration scale (PAS) and swallowing performance score (SPS) determined via MBS. Twenty-four (42%) patients had a PAS score over 6, implying aspiration. Patients with a SPS score over 5 are at risk of aspiration and those with a score of 7 absolutely require primary tube feeding. Twenty-five (43.9%) patients had a score over 5 and 13 patients had a score of 7. MBS, modified barium swallow.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541650&req=5

Figure 1: Penetration-aspiration scale (PAS) and swallowing performance score (SPS) determined via MBS. Twenty-four (42%) patients had a PAS score over 6, implying aspiration. Patients with a SPS score over 5 are at risk of aspiration and those with a score of 7 absolutely require primary tube feeding. Twenty-five (43.9%) patients had a score over 5 and 13 patients had a score of 7. MBS, modified barium swallow.
Mentions: The distributions of PAS and SPS values are shown in Fig. 1. Twenty-four (42%) patients had PAS values over 6, implying aspiration. Forty-one (71.9%) patients had a score of more than 3; 25 (43.9%) patients had a score greater than 5; and 13 patients had a SPS score of more than 7.

Bottom Line: The MBS results were rated on the 8-point penetration-aspiration scale (PAS) and swallowing performance status (SPS) score.Reduced base of the tongue (BOT) retraction (64.9%), reduced laryngeal elevation (57.9%), and cricopharyngeus (CP) dysfunction (47.4%) were found.Forty-one patients had a SPS score of more than 3, 25 patients had a score greater than 5, and 13 patients had a SPS score of more than 7.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology Head and Neck Surgery, CHA University, Bundang Medical Center, Seongnam, Korea.

ABSTRACT

Purpose: The purposes of this study were to evaluate specific dysphagia patterns and to identify the factors affecting dysphagia, especially aspiration, following treatment of head and neck cancer.

Materials and methods: A retrospective analysis of 57 patients was performed. Dysphagia was evaluated using a modified barium swallow (MBS) test. The MBS results were rated on the 8-point penetration-aspiration scale (PAS) and swallowing performance status (SPS) score.

Results: Reduced base of the tongue (BOT) retraction (64.9%), reduced laryngeal elevation (57.9%), and cricopharyngeus (CP) dysfunction (47.4%) were found. Reduced BOT retraction was correlated with clinical stage (p=0.011) and treatment modality (p=0.001). Aspiration in 42.1% and penetration in 33.3% of patients were observed. Twenty-four patients had PAS values over 6, implying aspiration. Forty-one patients had a SPS score of more than 3, 25 patients had a score greater than 5, and 13 patients had a SPS score of more than 7. Aspiration was found more often in patients with penetration (p=0.002) and in older patients (p=0.026). In older patients, abnormal swallowing caused aspiration even in those with a SPS score of more than 3, irrespective of stage or treatment, contrary to younger patients. Tube feeders (n=20) exhibited older age (65.0%), dysphagia/aspiration related structures (DARS) primaries (75.0%), higher stage disease (66.7%), and a history of radiotherapy (68.8%).

Conclusion: Reduced BOT retraction was the most common dysphagia pattern and was correlated with clinical stage and treatment regimens including radiotherapy. Aspiration was more frequent in patients who had penetration and in older patients. In contrast to younger patients, older patients showed greater risk of aspiration even with a single abnormal swallowing irrespective of stage or treatment.

Show MeSH
Related in: MedlinePlus