The clinical value of dysphagia preassessment in the management of head and neck cancer patients

Abstract

To review the aims and clinical value of a pretreatment dysphagia assessment in head and neck cancer patients. Studies show that the majority of head and neck cancer patients have a functional swallow, before they commence treatment. However, those with advanced and/or pharyngeal cancer are more likely to show signs of aspiration. Changes to swallowing performance can be observed on clinical tests and a number of biomechanical differences are seen on instrumental assessment. New evidence has demonstrated that swallowing assessment prior to the commencement of treatment is predictive of swallowing difficulties up to 1 year posttreatment. The type of surgical or oncological treatment seems to be an important factor for long-term swallowing dysfunction. A swallowing evaluation is multidimensional and tests include both the clinical and the patient perspective. A pretreatment dysphagia assessment is important for identifying swallowing difficulties and highlighting patients who are likely to develop chronic dysfunction. Predictive indicators can be used to tailor patient information for the likely functional impact of treatment.