Abstract
BackgroundUpper body motor function and swallowing may be affected after curative treatment for head and neck cancer. The aims of this study are to compare maximum mouth opening (MMO), temporomandibular dysfunction (TMD), cervical and shoulder active range of motion (AROM) and strength, and swallowing difficulty between survivors of head and neck cancer (sHNC) and healthy matched controls (HMC) and to examine the correlations between these outcomes in sHNC.MethodsThirty-two sHNC and 32 HMC participated on the study. MMO, TMD, cervical and shoulder AROM, cervical and shoulder strength, the SPADI shoulder pain and disability indices, the Eating Assessment Tool (EAT-10) score, swallowing difficulty as determined using a visual analogue scale (VAS), and the location of disturbances in swallowing, were recorded.ResultsMMO and cervical and shoulder AROM and strength were significantly lower in sHNC, whereas FAI, SPADI score, EAT-10 and VAS were higher. The MMO, TMD, cervical and shoulder AROM, and cervical shoulder strength values showed significant correlations (some direct, others inverse) with one another. Swallowing difficulty was inversely associated with the MMO, cervical AROM and shoulder strength.ConclusionCompared with controls, sHNC present smaller MMO, lower cervical and shoulder AROM, lower cervical and shoulder strength and higher perception of TMD, shoulder pain and disability and swallowing difficulty. sHNC suffer impaired swallowing related to lower MMO, presence of TMD, cervical AROM and shoulder strength values. Improving these variables via physiotherapy may reduce the difficulty in swallowing experienced by some sHNC.
Highlights
Head and neck cancer (HNC) refers to cancer of the nasal cavity and paranasal sinuses, the oral cavity, the salivary glands, pharynx and larynx
maximum mouth opening (MMO) and cervical and shoulder active range of motion (AROM) and strength were significantly lower in survivors of head and neck cancer (sHNC), whereas Fonseca Anamnestic Index (FAI), shoulder pain and disability index (SPADI) score, EAT-10 and visual analogue scale (VAS) were higher
Swallowing difficulty was inversely associated with the MMO, cervical AROM and shoulder strength
Summary
Head and neck cancer (HNC) refers to cancer of the nasal cavity and paranasal sinuses, the oral cavity, the salivary glands, pharynx and larynx. The worldwide incidence of HNC is some 650,000 cases per year; in Europe, this incidence reaches 140,000 cases, whereas in Spain HNC incidence is around 10,000 cases annually [1] It is more common in men than in women; the mean age at diagnosis is 50 years [2]. In MRND, all the local lymph nodes are removed, but one or more nonlymphatic structures are preserved (e.g., the spinal accessory nerve, the internal jugular vein or the sternocleidomastoid muscle). RND involves the extirpation of all ipsilateral lymph node groups from the lower border of the mandible to the clavicle, as well as the removal of the spinal accessory nerve, the internal jugular vein and the sternocleidomastoid muscle [7]. The aims of this study are to compare maximum mouth opening (MMO), temporomandibular dysfunction (TMD), cervical and shoulder active range of motion (AROM) and strength, and swallowing difficulty between survivors of head and neck cancer (sHNC) and healthy matched controls (HMC) and to examine the correlations between these outcomes in sHNC
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