Swallowing and communication outcomes following primary transoral robotic surgery for advanced or recurrent oropharyngeal cancer: Case series.

Charters, E; Bogaardt, H; Freeman-Sanderson, A; Ballard, K; Davies, S; Oates, J; Clark, J

Swallowing and communication outcomes following primary transoral robotic surgery for advanced or recurrent oropharyngeal cancer: Case series.

Charters, E Bogaardt, H Freeman-Sanderson, A

Ballard, K Davies, S Oates, J Clark, J

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Publisher:: Informa UK Limited
Publication Type:: Journal Article
Citation:: International journal of speech-language pathology, 2021, pp. 1-10
Issue Date:: 2021-09-21

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Field	Value	Language
dc.contributor.author	Charters, E
dc.contributor.author	Bogaardt, H
dc.contributor.author	Freeman-Sanderson, A https://orcid.org/0000-0003-2161-6421
dc.contributor.author	Ballard, K
dc.contributor.author	Davies, S
dc.contributor.author	Oates, J
dc.contributor.author	Clark, J
dc.date.accessioned	2021-11-26T01:18:03Z
dc.date.available	2021-11-26T01:18:03Z
dc.date.issued	2021-09-21
dc.identifier.citation	International journal of speech-language pathology, 2021, pp. 1-10
dc.identifier.issn	1754-9507
dc.identifier.issn	1754-9515
dc.identifier.uri	http://hdl.handle.net/10453/151856
dc.description.abstract	<i>Purpose</i>: Transoral robotic surgery (TORS) is most commonly undertaken as a minimally invasive approach for early staged oropharyngeal cancers (OPC), with good expectations for a functional recovery. A small number of patients, however, require TORS for recurrent or advanced OPC tumours. Their prospects for longer term recovery of communication and swallowing are both unreported and hypothesised to be poorer than the majority of TORS cases. This case-series describes the recovery of swallowing and communication function post-TORS for this unique group of patients.<i>Method</i>: Consecutive recruitment was carried out prospectively at a quaternity oncology referral centre. Participants were aged 18 years and older, with reconstruction involving a free-flap and tracheostomy. Patients were assessed using Fibreoptic Endoscopic Evaluation of Swallowing, and clinician and patient-reported outcomes 12-months post-TORS. Their pre-operative baseline and three-month post-TORS FOIS scores were collated retrospectively.<i>Result</i>: Six participants were recruited over an 18-month period of which three patients underwent TORS for recurrent, and three for advanced OPC. Those with recurrent-OPC did not return to their baseline diet and demonstrated post-swallow silent aspiration of pharyngeal residue. Three of the six were rehabilitated back to their baseline intelligibility (100%).<i>Conclusion</i>: TORS in the recurrent OPC setting appears congruent with high rates of silent aspiration and prolonged reliance on a feeding tube due to oropharyngeal dysphagia, as well as compromised intelligibility. This is the first study that evaluates this instrumentally and provides clinically relevant evidence to inform practice.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Informa UK Limited
dc.relation.ispartof	International journal of speech-language pathology
dc.relation.isbasedon	10.1080/17549507.2021.1977388
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1702 Cognitive Sciences, 2004 Linguistics
dc.subject.classification	Speech-Language Pathology & Audiology
dc.title	Swallowing and communication outcomes following primary transoral robotic surgery for advanced or recurrent oropharyngeal cancer: Case series.
dc.type	Journal Article
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1702 Cognitive Sciences
utslib.for	2004 Linguistics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Speech Pathology
utslib.copyright.status	closed_access	*
dc.date.updated	2021-11-26T01:18:02Z
pubs.publication-status	Published

Abstract:

Purpose: Transoral robotic surgery (TORS) is most commonly undertaken as a minimally invasive approach for early staged oropharyngeal cancers (OPC), with good expectations for a functional recovery. A small number of patients, however, require TORS for recurrent or advanced OPC tumours. Their prospects for longer term recovery of communication and swallowing are both unreported and hypothesised to be poorer than the majority of TORS cases. This case-series describes the recovery of swallowing and communication function post-TORS for this unique group of patients.Method: Consecutive recruitment was carried out prospectively at a quaternity oncology referral centre. Participants were aged 18 years and older, with reconstruction involving a free-flap and tracheostomy. Patients were assessed using Fibreoptic Endoscopic Evaluation of Swallowing, and clinician and patient-reported outcomes 12-months post-TORS. Their pre-operative baseline and three-month post-TORS FOIS scores were collated retrospectively.Result: Six participants were recruited over an 18-month period of which three patients underwent TORS for recurrent, and three for advanced OPC. Those with recurrent-OPC did not return to their baseline diet and demonstrated post-swallow silent aspiration of pharyngeal residue. Three of the six were rehabilitated back to their baseline intelligibility (100%).Conclusion: TORS in the recurrent OPC setting appears congruent with high rates of silent aspiration and prolonged reliance on a feeding tube due to oropharyngeal dysphagia, as well as compromised intelligibility. This is the first study that evaluates this instrumentally and provides clinically relevant evidence to inform practice.

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http://hdl.handle.net/10453/151856