A videofluroscopic swallow study (VFSS), also known as modified barium swallow (MBS) offers a dynamic view of swallow biomechanics and associated swallowing physiology. The authors of this paper investigated whether quantitative timing and displacement measures of key structures involved in swallowing had any value in predicting post-treatment swallowing outcomes captured by the Functional Oral Intake Scale (FOIS) and the Penetration-Aspiration Scale (PAS). They used the Swallowtail software programme to compute 16 timing and five displacement measures across five anatomical sites: pharynx, larynx, hyoid, upper oesophageal sphincter and the soft palate. The sample included thin and pudding bolus trials undertaken on 31 patients who underwent VFSS pre and post radiotherapy. They compared their findings to the FOIS (dichotimised: FOIS ≤ 3, indicating feeding tube use, and FOIS ≥ 4, indicating full oral diet) and PAS ≤ 5, indicating possible penetration but no aspiration, and PAS ≥ 6, indicating aspiration. The authors reported the following significant findings: Total pharyngeal transit time discriminated between post radiotherapy diet levels for FOIS ≤ 3 and FOIS ≥ 4 suggesting that this measure may have some prognostic value. There were no observed relationships with the PAS score. This study offers interesting insights into possible associations between objective measures, clinician-rated, and patient-reported swallowing outcomes.
Predicting swallowing outcomes post radiotherapy for head and neck cancer
Reviewed by Roganie Govender
Predicting Swallowing Outcomes from Objective Videofluoroscopic Timing and Displacement Measures in Head and Neck Cancer Patients.
CONTRIBUTOR
Roganie Govender
University College London, Head & Neck Academic Centre, UK.
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