Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Speech-Language Pathology

First Advisor

Cesar Ruiz

Defense Date

1-1-2018

Abstract

Abstract Functional Swallow-Related Outcomes Following Transoral Robotic Surgery for Base of Tongue Carcinoma. Kelly M. Salmon, 2018: Applied Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education. Keywords: Transoral robotic surgery, Lingual strength, Oropharyngeal cancer, Swallowing, Functional outcomes In an era where the incidence of oropharyngeal cancer has been growing steadily, there is a limited amount of research exploring functional outcomes for individuals whose definitive cancer management approach includes surgical resection with or without adjuvant treatment or organ preservation approaches including primary radiation or chemoradiation. This applied dissertation was designed to examine functional outcome measures related to tongue strength, swallow function, oral intake, and quality of life in individuals newly diagnosed with base of tongue cancer whose treatment plan includes surgical resection via transoral robotic surgery (TORS) with or without a plan for subsequent adjuvant treatment in the form of radiation or chemoradiation. This dissertation study aimed to determine whether TORS resection for early-stage base of the tongue (BOT) SCCA affected: (a) lingual strength, (b) swallow safety and efficiency, (c) oral intake, and (d) swallowing-related quality of life. Nine individuals meeting the inclusion criteria for this dissertation study were recruited to participate from March 2017 to April 2018. Each participant was evaluated at four distinct time points: (a) preoperatively, (b) 1-week postoperatively, (c) 1-month postoperatively, and (d) 3-months postoperatively. The study was designed to capture the acute effect of TORS and did not account for changes in function that might have occurred after the onset of adjuvant treatment(s). The following data were collected at each time point: (a) maximum isometric lingual pressure, (b) Penetration-Aspiration Scale scores as observed during a FEES examination, (c) The Yale Pharyngeal Residue Severity Rating Scale scores as observed during a FEES examination, (d) The Functional Oral Intake Scale (FOIS) score, and (e) The Eating Assessment Tool (EAT-10) score. Based on analysis of the data, it was shown that a significant decline in maximum isometric lingual pressure, EAT-10 scores, and FOIS scores occurred between preoperative baseline measurements and 1-week post-surgery. All participants in the study demonstrated a return to levels at or near their baseline level of function for maximum isometric lingual pressure, EAT-10 score, and FOIS score by 1- or 3-months post-surgery. There were no significant changes in swallow safety or efficiency observed at any time point during the study.

Keywords

functional outcomes; lingual strength; oropharyngeal cancer; swallowing; transoral robotic surgery

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