Parsiyel Larenjektomilerde Preoperatif Yutma Terapisinin Yutma Fonksiyonu Üzerine Etkisinin Araştırılması

Abstract

Eliküçük, Ç., Investigation of the Effect of Preoperative Swallowing Therapy on Swallowing Function in Partial Laryngectomies, Hacettepe University Graduate School of Health Sciences Language and Speech Therapy Program Doctoral Thesis, Ankara, 2024. After partial laryngectomy surgery, swallowing safety and effectiveness are significantly affected and the quality of life of head and neck cancer (HNC) patients is reduced. Positive effects of postoperative swallowing therapy on dysphagia have been reported in partial laryngectomies; however, due to postoperative fatigue, poor mood, pain and removal of structures, correct application of exercises can be challenging for both patients and speech-language therapists (SLTs). The aim of this study was to investigate the effect of preoperative swallowing therapy on postoperative swallowing function and quality of life in patients scheduled for partial laryngectomy. The study included 30 patients with HNC treated with partial laryngectomy. The study group (n=16) who received both preoperative and postoperative swallowing therapy and the control group (n=14) who received only postoperative swallowing therapy They were evaluated at 5 different time points: preoperative, postoperative 5-7 days, 1 month, 3 months and 6 months after surgery. Fiberoptic endoscopic swallowing evaluation (FEES) was performed, Penetration-Aspiration Scale (PAS) scores were determined for all consistencies according to the International Dysphagia Diet Standardization Initiative (IDDSI) Protocol, and the residue in the vallecula and priform sinuses were scored with the Yale Pharyngeal Residue Severity Rating Scale. Oral intake levels were determined according to FOIS and oral intake times were recorded. Swallowing-related quality of life was determined using the European Organization for Research and Treatment of Cancer health-related quality of life scale developed specifically for cancer patients-Turkish (EORTC QLQ-C30 Version 3.0), the quality of life module for HNC patients-Turkish (EORTC QLQ-H&N35) and the Eating Assessment Tool-Turkish (EAT-10).When the findings were analyzed, it was observed that EAT-10 and PAS scores and residual amounts of the patients who received and did not receive swallowing therapy before surgery decreased significantly after surgery and FOIS levels increased significantly in the postoperative period (p < 0.05). However, this positive change in swallowing function was found to be earlier in the group that received swallowing therapy before surgery. In addition, the time to oral intake was found to be significantly shorter in patients who received preoperative swallowing therapy than in patients who did not receive preopreative swallowing therapy (p <0.05). In conclusion, it was observed that swallowing therapy applied in the preoperative period provided an advantage in terms of functionality for patients. In this study, it is thought that findings that will guide otolaryngologists and SLTs in the management of dysphagia in laryngeal cancer patients planned for partial laryngectomy were obtained.