Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: a systematic review protocol.

Abstract

REVIEW QUESTION / OBJECTIVE What are the swallowing outcomes of primary surgical resection with primary free flap reconstruction with or without adjuvant therapy for the treatment of oral or oropharyngeal squamous cell carcinoma? The objective of this systematic review is to investigate swallowing outcomes following primary surgical resection and free flap reconstruction for the treatment of patients with oral and oropharyngeal squamous cell carcinoma. More specifically, the objectives are to evaluate dysphagia following primary surgical resection with or without adjuvant therapy with the use of objective investigations (videofluoroscopy, fiberoptic endoscopic evaluations of swallowing, manometry, gastrostomy dependency and tracheostomy dependency) and subjective questionnaires (MD Anderson Dysphagia Inventory, University of Washington Quality of Life Questionnaire and Functional Oral Intake Score). INCLUSION CRITERIA Types of participants The participants of interest for the review will be patients of 18 years of age or older with a histological diagnosis of oral or oropharyngeal squamous cell carcinoma. Histological diagnosis of malignancy is required to confirm the presence of malignancy. Treatment must be aimed at curative intent, with locoregional control at the time of swallowing evaluation, as swallowing outcomes at this time would be likely representative of swallowing function that is not impaired by the primary cancer. Exclusion criteria include patients with mandibular or maxillary involvement requiring osseous free flap reconstruction, distant metastasis at diagnosis, presence of other malignancies, and diagnosis of dementia, stroke or neurological disease prior to treatment. Osseous free flap reconstructions are typically associated with larger primary resections, thus affecting swallowing outcomes. Dementia, stroke TRUNCATED AT 250 WORDS