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Effects of Oral Cancer Surgery on Upper Esophageal Opening During Swallowing
Effects of Oral Cancer Surgery on Upper Esophageal Opening During Swallowing
Effects of Oral Cancer Surgery on Upper Esophageal Opening During Swallowing

Detailed Information

자료유형  
 학위논문 서양
최종처리일시  
20250211153121
ISBN  
9798346849278
DDC  
616.8
저자명  
Knigge, Molly A.
서명/저자  
Effects of Oral Cancer Surgery on Upper Esophageal Opening During Swallowing
발행사항  
[Sl] : The University of Wisconsin - Madison, 2024
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2024
형태사항  
139 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-06, Section: A.
주기사항  
Advisor: Thibeault, Susan.
학위논문주기  
Thesis (Ph.D.)--The University of Wisconsin - Madison, 2024.
초록/해제  
요약Background: Improved survival following oral cancer remains threatened by reduced quality of life and poor health outcomes related to swallowing dysfunction. Dysphagia following surgery includes reduced upper esophageal sphincter opening, though no treatment standards have been established. Two studies conducted aimed to: 1) compare measures of UES function in post-operative oral cancer patients to normative measures, and 2) examine relationships between UES function and swallowing-related outcomes.Methods: Patients with oral cancer were recruited following surgical resection of tongue or floor of mouth and underwent concurrent videofluoroscopic swallow study and high-resolution pharyngeal manometry. Swallowing outcomes were collected using the M.D. Anderson Dysphagia Inventory and Dynamic Imaging Grade of Swallowing Toxicity. Consented participants were age- and sex-matched to healthy adult videofluoroscopic and manometric data. The second study extracted oncologic data from a head and neck cancer database and electronic medical record. Automated analysis was used to derive UES and pharyngeal manometry metrics, while videofluoroscopic imaging was analyzed using the Analysis of Swallowing Physiology: Events, Kinematics and Timing method. Results: Prospective data were collected from four patient participants and compared to controls, while retrospective data identified 23 studies eligible for analysis. No significant difference was found in UES maximum admittance between participants with oral cancer and controls (p = 0.1312), nor were other manometric UES measures found to differ significantly. Mean global pharyngeal contractile integrals following surgery were significantly lower than controls (p = 0.0230). In controls with lifestyle risk factors, peak hyoid position did not significantly differ from oral cancer patients. In retrospective analysis, median peak hyoid excursion (p = 0.0102), UES diameter (p = 0.0114), and pharyngeal residue area (p 0.0001) were significantly different from healthy reference values (Steele et al., 2023). Neither study showed significant relationships between UES function and patient-rated or clinician-rated swallowing outcomes. Conclusions: Measures of UES function following oral cancer surgery showed no relationship to swallowing outcomes prior to adjuvant radiotherapy. Manometric measures of global pharyngeal function, however, remained significantly reduced at one month after surgery. These findings suggest that future research focused on pharyngeal pressure generation and efficiency may better target post-operative treatment approaches.
일반주제명  
Speech therapy
일반주제명  
Oncology
일반주제명  
Therapy
일반주제명  
Surgery
일반주제명  
Medical imaging
키워드  
Dysphagia
키워드  
Head and neck surgery
키워드  
Manometry
키워드  
Oral cancer
키워드  
Videofluoroscopy
기타저자  
The University of Wisconsin - Madison Clinical Investigation - MED
기본자료저록  
Dissertations Abstracts International. 86-06A.
전자적 위치 및 접속  
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MARC

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■1001  ▼aKnigge,  Molly  A.
■24510▼aEffects  of  Oral  Cancer  Surgery  on  Upper  Esophageal  Opening  During  Swallowing
■260    ▼a[Sl]▼bThe  University  of  Wisconsin  -  Madison▼c2024
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2024
■300    ▼a139  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-06,  Section:  A.
■500    ▼aAdvisor:  Thibeault,  Susan.
■5021  ▼aThesis  (Ph.D.)--The  University  of  Wisconsin  -  Madison,  2024.
■520    ▼aBackground:  Improved  survival  following  oral  cancer  remains  threatened  by  reduced  quality  of  life  and  poor  health  outcomes  related  to  swallowing  dysfunction.  Dysphagia  following  surgery  includes  reduced  upper  esophageal  sphincter  opening,  though  no  treatment  standards  have  been  established.  Two  studies  conducted  aimed  to:  1)  compare  measures  of  UES  function  in  post-operative  oral  cancer  patients  to  normative  measures,  and  2)  examine  relationships  between  UES  function  and  swallowing-related  outcomes.Methods:  Patients  with  oral  cancer  were  recruited  following  surgical  resection  of  tongue  or  floor  of  mouth  and  underwent  concurrent  videofluoroscopic  swallow  study  and  high-resolution  pharyngeal  manometry.  Swallowing  outcomes  were  collected  using  the  M.D.  Anderson  Dysphagia  Inventory  and  Dynamic  Imaging  Grade  of  Swallowing  Toxicity.  Consented  participants  were  age-  and  sex-matched  to  healthy  adult  videofluoroscopic  and  manometric  data.  The  second  study  extracted  oncologic  data  from  a  head  and  neck  cancer  database  and  electronic  medical  record.  Automated  analysis  was  used  to  derive  UES  and  pharyngeal  manometry  metrics,  while  videofluoroscopic  imaging  was  analyzed  using  the  Analysis  of  Swallowing  Physiology:  Events,  Kinematics  and  Timing  method. Results:  Prospective  data  were  collected  from  four  patient  participants  and  compared  to  controls,  while  retrospective  data  identified  23  studies  eligible  for  analysis.  No  significant  difference  was  found  in  UES  maximum  admittance  between  participants  with  oral  cancer  and  controls  (p  =  0.1312),  nor  were  other  manometric  UES  measures  found to  differ  significantly.  Mean  global  pharyngeal  contractile  integrals  following  surgery  were  significantly  lower  than  controls  (p  =  0.0230).  In  controls  with  lifestyle  risk  factors,  peak  hyoid  position  did  not  significantly  differ  from  oral  cancer  patients.  In  retrospective  analysis,  median  peak  hyoid  excursion  (p  =  0.0102),  UES  diameter  (p  =  0.0114),  and  pharyngeal  residue  area  (p  0.0001)  were  significantly  different  from  healthy  reference  values  (Steele  et  al.,  2023).  Neither  study  showed  significant  relationships  between  UES  function  and  patient-rated  or  clinician-rated  swallowing  outcomes. Conclusions:  Measures  of  UES  function  following  oral  cancer  surgery  showed  no  relationship  to  swallowing  outcomes  prior  to  adjuvant  radiotherapy.  Manometric  measures  of  global  pharyngeal  function,  however,  remained  significantly  reduced  at  one  month  after  surgery.  These  findings  suggest  that  future  research  focused  on  pharyngeal  pressure  generation  and  efficiency  may  better  target  post-operative  treatment  approaches.
■590    ▼aSchool  code:  0262.
■650  4▼aSpeech  therapy
■650  4▼aOncology
■650  4▼aTherapy
■650  4▼aSurgery
■650  4▼aMedical  imaging
■653    ▼aDysphagia
■653    ▼aHead  and  neck  surgery
■653    ▼aManometry
■653    ▼aOral  cancer
■653    ▼aVideofluoroscopy
■690    ▼a0460
■690    ▼a0576
■690    ▼a0574
■690    ▼a0992
■690    ▼a0212
■71020▼aThe  University  of  Wisconsin  -  Madison▼bClinical  Investigation  -  MED.
■7730  ▼tDissertations  Abstracts  International▼g86-06A.
■790    ▼a0262
■791    ▼aPh.D.
■792    ▼a2024
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17165084▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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