Effects of Change in Tongue Pressure and Salivary Flow Rate on Swallow Efficiency Following Chemoradiation Treatment for Head and Neck Cancer

Nicole M Rogus-Pulia; Charles Larson; Bharat B Mittal; Marge Pierce; Steven Zecker; Korey Kennelty; Amy Kind; Nadine P Connor

doi:10.1007/s00455-016-9733-7

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Effects of Change in Tongue Pressure and Salivary Flow Rate on Swallow Efficiency Following Chemoradiation Treatment for Head and Neck Cancer

Journal article

Peer reviewed

Effects of Change in Tongue Pressure and Salivary Flow Rate on Swallow Efficiency Following Chemoradiation Treatment for Head and Neck Cancer

Nicole M Rogus-Pulia, Charles Larson, Bharat B Mittal, Marge Pierce, Steven Zecker, Korey Kennelty, Amy Kind and Nadine P Connor

Dysphagia, Vol.31(5), pp.687-696

10/2016

DOI: 10.1007/s00455-016-9733-7

PMCID: PMC5018456

PMID: 27492408

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http://doi.org/10.1007/s00455-016-9733-7View

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Abstract

Patients treated with chemoradiation for head and neck cancer frequently develop dysphagia. Tissue damage to the oral tongue causing weakness along with decreases in saliva production may contribute to dysphagia. Yet, effects of these variables on swallowing-related measures are unclear. The purpose of this study was (1) to determine effects of chemoradiation on tongue pressures, as a surrogate for strength, and salivary flow rates and (2) to elucidate relationships among tongue pressures, saliva production, and swallowing efficiency by bolus type. Twenty-one patients with head and neck cancer treated with chemoradiation were assessed before and after treatment and matched with 21 healthy control participants who did not receive chemoradiation. Each participant was given a questionnaire to rate dysphagia symptoms. Videofluoroscopic Evaluation of Swallowing (VFES) was used to determine swallowing efficiency; the Saxon test measured salivary flow rate; and the Iowa Oral Performance Instrument (IOPI) was used for oral tongue maximum and endurance measures. Results revealed significantly lower tongue endurance measures for patients post-treatment as compared to controls (p = .012). Salivary flow rates also were lower compared to pre-treatment (p = .000) and controls (p = .000). Simple linear regression analyses showed that change in salivary flow rate was predictive of change in swallow efficiency measures from pre- to post-treatment for 1 mL thin liquid (p = .017), 3 mL nectar-thick liquid (p = .026), and 3 mL standard barium pudding (p = .011) boluses. Based on these findings, it appears that chemoradiation treatment affects tongue endurance and salivary flow rate, and these changes may impact swallow efficiency. These factors should be considered when planning treatment for dysphagia.

Chemoradiotherapy - adverse effects

Humans

Middle Aged

Tongue - physiopathology

Head and Neck Neoplasms - therapy

Head and Neck Neoplasms - physiopathology

Male

Treatment Outcome

Deglutition - physiology

Pressure

Case-Control Studies

Saliva - physiology

Young Adult

Adolescent

Aged, 80 and over

Adult

Deglutition Disorders - etiology

Female

Aged

Deglutition Disorders - physiopathology

Details

Title: Subtitle: Effects of Change in Tongue Pressure and Salivary Flow Rate on Swallow Efficiency Following Chemoradiation Treatment for Head and Neck Cancer
Creators: Nicole M Rogus-Pulia - Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53705, USA. npulia@wisc.edu
Charles Larson - Department of Communication Sciences and Disorders, Northwestern University, Frances Searle Building, Evanston, IL, 60208, USA
Bharat B Mittal - Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
Marge Pierce - Radiation Oncology, Northwestern Memorial Hospital, Chicago, IL, 60611, USA
Steven Zecker - Department of Communication Sciences and Disorders, Northwestern University, Frances Searle Building, Evanston, IL, 60208, USA
Korey Kennelty - School of Pharmacy, University of Wisconsin- Madison, Madison, USA
Amy Kind - Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53705, USA
Nadine P Connor - Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, USA
Resource Type: Journal article
Publication Details: Dysphagia, Vol.31(5), pp.687-696
DOI: 10.1007/s00455-016-9733-7
PMID: 27492408
PMCID: PMC5018456
NLM abbreviation: Dysphagia
ISSN: 0179-051X
eISSN: 1432-0460
Publisher: United States
Grant note: P30 CA060553 / NCI NIH HHS K23 AG034551 / NIA NIH HHS
Language: English
Date published: 10/2016
Academic Unit: Family and Community Medicine; Pharmacy Practice and Science; Injury Prevention Research Center
Record Identifier: 9984065696202771

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