Abstract：
OBJECTIVE: To perform a systematic review of studies reporting swallow-associated outcomes in patients who received surgery for head and neck cancer (HNC), informed by an anatomic and physiologic framework of pharyngeal phase of swallowing (Pearson\'s dual-sling model).
METHODS: PUBMED and Google Scholar databases were searched for peer-reviewed papers published between 1990 and 2019 using relevant MeSH terms. Exclusion criteria were 1) discussions comparing reconstruction techniques, 2) case-report/series (n < 10), 3) perspective articles, 4) papers comparing objective instrumental methods of swallowing evaluation, 5) animal/cadaver studies, 6) no instrumental or validated swallow assessment tools used, 7) papers that discuss/include radiotherapy treatment, 8) systematic reviews, 9) papers that discuss swallow training or rehabilitation methods. Two investigators reviewed papers meeting inclusion/exclusions criteria. Muscles resected, anatomic resection site, swallow outcomes, and patient treatment variables were collected.
RESULTS: A total of 115,020 peer-reviewed papers were identified. 74 papers were relevant to this review, 18 met inclusion and exclusion criteria, and none discussed surgical impact on the pharyngeal phase of swallowing using Pearson\'s dual-sling model. Most papers discussed the effect of tongue-base, supraglottic, or regional anatomic resection. Post-surgical resection Follow-up times ranged from 1 to 13 months. 67% of studies used objective instrumental swallow studies; 22% used patient reported outcome measures. Follow up time since surgical resection, time to feeding tube removal, feeding tube present/absent, aspiration severity were used to define dysphagia endpoints.
CONCLUSIONS: To date, no surgical HNC studies have used the dual-sling mechanism to guide study design, and dysphagia assessment has been inconsistent. To counsel patients on the effects of surgery on pharyngeal phase of swallow function, specialists need physiologically grounded research that correlates muscles resected with consistent measures of swallow function.
METHODS: PUBMED and Google Scholar databases were searched for peer-reviewed papers published between 1990 and 2019 using relevant MeSH terms. Exclusion criteria were 1) discussions comparing reconstruction techniques, 2) case-report/series (n < 10), 3) perspective articles, 4) papers comparing objective instrumental methods of swallowing evaluation, 5) animal/cadaver studies, 6) no instrumental or validated swallow assessment tools used, 7) papers that discuss/include radiotherapy treatment, 8) systematic reviews, 9) papers that discuss swallow training or rehabilitation methods. Two investigators reviewed papers meeting inclusion/exclusions criteria. Muscles resected, anatomic resection site, swallow outcomes, and patient treatment variables were collected.
RESULTS: A total of 115,020 peer-reviewed papers were identified. 74 papers were relevant to this review, 18 met inclusion and exclusion criteria, and none discussed surgical impact on the pharyngeal phase of swallowing using Pearson\'s dual-sling model. Most papers discussed the effect of tongue-base, supraglottic, or regional anatomic resection. Post-surgical resection Follow-up times ranged from 1 to 13 months. 67% of studies used objective instrumental swallow studies; 22% used patient reported outcome measures. Follow up time since surgical resection, time to feeding tube removal, feeding tube present/absent, aspiration severity were used to define dysphagia endpoints.
CONCLUSIONS: To date, no surgical HNC studies have used the dual-sling mechanism to guide study design, and dysphagia assessment has been inconsistent. To counsel patients on the effects of surgery on pharyngeal phase of swallow function, specialists need physiologically grounded research that correlates muscles resected with consistent measures of swallow function.
摘要：
目的：对报告接受头颈部癌（HNC）手术的患者吞咽相关结局的研究进行系统评价，咽部吞咽阶段的解剖和生理框架（Pearson的双吊带模型）。
方法：使用相关MeSH术语搜索了PUBMED和GoogleScholar数据库，以查找1990年至2019年之间发表的同行评审论文。排除标准是1)讨论比较重建技术，2)病例报告/系列(n<10)，3)透视文章，4)论文比较了吞咽评估的客观工具方法，5）动物/尸体研究，6)没有使用仪器或经过验证的吞咽评估工具，7）讨论/包括放射治疗的论文，8)系统审查，9）讨论吞咽训练或康复方法的论文。两名研究者审查了符合纳入/排除标准的论文。切除的肌肉,解剖切除部位,吞咽结果，并收集患者治疗变量。
结果：共确定了115,020篇同行评审论文。74篇论文与这篇综述有关，18符合纳入和排除标准，没有人使用Pearson的双吊带模型讨论手术对咽部吞咽期的影响。大多数论文都讨论了舌根的影响，上声乐，或局部解剖切除.手术切除后随访时间为1至13个月。67%的研究使用客观工具吞咽研究；22%使用患者报告的结果指标。手术切除后的随访时间，取下进料管的时间，存在/不存在饲管，误吸严重程度用于定义吞咽困难终点.
结论：迄今为止，没有外科HNC研究使用双吊带机制来指导研究设计，和吞咽困难的评估不一致。为患者提供有关手术对咽期吞咽功能影响的建议，专家需要进行生理基础研究，以将切除的肌肉与吞咽功能的一致测量相关联。
方法：使用相关MeSH术语搜索了PUBMED和GoogleScholar数据库，以查找1990年至2019年之间发表的同行评审论文。排除标准是1)讨论比较重建技术，2)病例报告/系列(n<10)，3)透视文章，4)论文比较了吞咽评估的客观工具方法，5）动物/尸体研究，6)没有使用仪器或经过验证的吞咽评估工具，7）讨论/包括放射治疗的论文，8)系统审查，9）讨论吞咽训练或康复方法的论文。两名研究者审查了符合纳入/排除标准的论文。切除的肌肉,解剖切除部位,吞咽结果，并收集患者治疗变量。
结果：共确定了115,020篇同行评审论文。74篇论文与这篇综述有关，18符合纳入和排除标准，没有人使用Pearson的双吊带模型讨论手术对咽部吞咽期的影响。大多数论文都讨论了舌根的影响，上声乐，或局部解剖切除.手术切除后随访时间为1至13个月。67%的研究使用客观工具吞咽研究；22%使用患者报告的结果指标。手术切除后的随访时间，取下进料管的时间，存在/不存在饲管，误吸严重程度用于定义吞咽困难终点.
结论：迄今为止，没有外科HNC研究使用双吊带机制来指导研究设计，和吞咽困难的评估不一致。为患者提供有关手术对咽期吞咽功能影响的建议，专家需要进行生理基础研究，以将切除的肌肉与吞咽功能的一致测量相关联。
