PDF(Pubmed)
Abstract：
BACKGROUND: It is controversial whether transoral resection for early pharyngolaryngeal cancer preserves swallowing function and quality of life. We investigated swallowing function and quality of life before and after transoral videolaryngoscopic surgery (TOVS).
METHODS: Seventy-three patients with pharyngolaryngeal cancer who underwent TOVS between July 2012 and July 2022 were enrolled in this prospective analysis. The Hyodo score and European Organization for Research and Treatment of Cancer Quality of Life Questionnaires were recorded preoperatively and at three, six, and 12 months postoperatively, in addition to the postoperative functional outcome swallowing scale (FOSS) at six months postoperatively.
RESULTS: Although most patients could consume food orally without restrictions with a preferable FOSS score, 23 patients showed impaired Hyodo scores. Age ≥65 years significantly predicted impaired swallowing. Sub-scores of the impaired patient group showed worsening for the glottal closure reflex when the endoscope touched the epiglottis or arytenoid, as well as a reduction in the extent of pharyngeal clearance following the ingestion of blue-dyed water.
CONCLUSIONS: After TOVS, swallowing function is generally well preserved. Elderly patients, especially those with laryngeal hypoesthesia and poor clearance, are at risk of swallowing dysfunction.
METHODS: Seventy-three patients with pharyngolaryngeal cancer who underwent TOVS between July 2012 and July 2022 were enrolled in this prospective analysis. The Hyodo score and European Organization for Research and Treatment of Cancer Quality of Life Questionnaires were recorded preoperatively and at three, six, and 12 months postoperatively, in addition to the postoperative functional outcome swallowing scale (FOSS) at six months postoperatively.
RESULTS: Although most patients could consume food orally without restrictions with a preferable FOSS score, 23 patients showed impaired Hyodo scores. Age ≥65 years significantly predicted impaired swallowing. Sub-scores of the impaired patient group showed worsening for the glottal closure reflex when the endoscope touched the epiglottis or arytenoid, as well as a reduction in the extent of pharyngeal clearance following the ingestion of blue-dyed water.
CONCLUSIONS: After TOVS, swallowing function is generally well preserved. Elderly patients, especially those with laryngeal hypoesthesia and poor clearance, are at risk of swallowing dysfunction.
摘要：
背景：经口切除早期咽喉癌是否能保留吞咽功能和生活质量存在争议。我们调查了经口视频喉镜手术（TOVS）前后的吞咽功能和生活质量。
方法：在2012年7月至2022年7月期间接受TOVS的73例咽喉癌患者纳入本前瞻性分析。术前记录Hyodo评分和欧洲癌症研究与治疗组织生活质量问卷，六,术后12个月，除了术后6个月的术后功能结局吞咽量表（FOSS）。
结果：尽管大多数患者可以不受限制地口服食物，但FOSS评分较好，23例患者表现出受损的Hyodo评分。年龄≥65岁可显著预测吞咽受损。受损患者组的子评分显示，当内窥镜接触会厌或蝶窦时，声门闭合反射恶化，以及摄入蓝色染水后咽部间隙的减少。
结论：在TOVS之后，吞咽功能通常保存良好。老年患者,尤其是那些喉部感觉减退和清除率差的人，有吞咽功能障碍的风险。
方法：在2012年7月至2022年7月期间接受TOVS的73例咽喉癌患者纳入本前瞻性分析。术前记录Hyodo评分和欧洲癌症研究与治疗组织生活质量问卷，六,术后12个月，除了术后6个月的术后功能结局吞咽量表（FOSS）。
结果：尽管大多数患者可以不受限制地口服食物，但FOSS评分较好，23例患者表现出受损的Hyodo评分。年龄≥65岁可显著预测吞咽受损。受损患者组的子评分显示，当内窥镜接触会厌或蝶窦时，声门闭合反射恶化，以及摄入蓝色染水后咽部间隙的减少。
结论：在TOVS之后，吞咽功能通常保存良好。老年患者,尤其是那些喉部感觉减退和清除率差的人，有吞咽功能障碍的风险。
