SWALLOWING ASSESSMENT IN CANCER LARYNX PATIENTS TREATED WITH RADIOTHERAPY OR CHEMORADIOTHERAPY

Abstract

Radiation-associated dysphagia (RAD) refers to difficulty in swallowing resulting from head and neck radiotherapy or chemo-radiotherapy. It leads to impaired swallowing efficiency and safety and affects over 50% of patients. It is a significant concern in managing cancer larynx patients. Radiotherapy causes acute effects such as mucositis, airway edema, and neuropathy leading to aspiration. It also causes late effects such as xerostomia, fibrosis, chondritis, soft tissue necrosis, and stenosis. Oropharyngeal dysphagia diagnosis is established through screening and comprehensive assessment, including both instrumental and non-instrumental procedures. There are few cancer-specific tools available to quantify the precise physiological alterations in swallowing during HNC diagnosis and treatment. MASA-C (Mann Assessment of Swallowing Ability - Cancer version) is a comprehensive non-instrumental tool used by the clinician to assess swallowing ability. FEES (fiber-optic endoscopic evaluation of swallowing) is considered a gold standard instrumental tool for assessment of swallowing safety and efficiency. Aim of the Work:To evaluate the accuracy of MASA-c; a non-instrumental swallowing assessment tool, in detecting aspiration compared to FEES; an instrumental swallowing assessment tool, in patients with laryngeal cancer after radiotherapy (RT) or chemoradiotherapy (CRT).