The relationship between MBS findings and dysphagia-specific QOL

Abstract

Objectives: The modified barium swallow (MBS) is frequently used to evaluate dysphagia in the head and neck cancer population. The relationship between MBS findings and dysphagia symptoms, however, is not well understood. The present study seeks to determine whether an association exists between MBS parameters and the M.D. Anderson Dysphagia Inventory (MDADI), a dysphagia-specific quality of life (QOL) measure. Methods: Cross-sectional study of adult subjects (n = 42) with no evidence of disease 12 months or more after treatment of a stage III or IV squamous cell carcinoma of the oropharynx or larynx. All subjects completed the MDADI followed by MBS. The MBS examinations were scored for the nonlaryngectomy group (n = 28) using the validated Pentration-Aspiration Scale (PAS). Additional MBS parameters assessed include tongue base retraction, maximal hyoid excursion, maximal laryngeal excursion, and maximal pharyngo-esophageal segment opening. Results: There were no significant differences in MDADI scores between subjects with penetration and/or aspiration on MBS when compared to subjects with no penetration and/or aspiration. The penetration-aspiration group demonstrated a trend ( P = 0.09) toward worse scores on the functional subscale of the MDADI which may indicate greater difficulty when eating in public and with food preparation. Conclusions: The presence of penetration or aspiration on MBS does not predict the degree to which dysphagia effects quality of life. Some patients with penetration and aspiration have few dysphagia-related symptoms, whereas others without penetration or aspiration are greatly impaired. The identification of MBS parameters that are more predictive of dysphagia-related quality of life may help to improve the validity and reliability of the MBS.