Objective To appraise the current videofluoroscopic evidence around the reduction of

Objective To appraise the current videofluoroscopic evidence around the reduction of aspiration using thickened liquids in the head and neck cancer population. detail predominantly explained heterogeneous study samples with small sample sizes making for hard interpretation and generalization of results. Rates of aspiration were typically not reported by bolus regularity despite the fact that a variety of stimulus consistencies was used during VFSS. Studies confirmed that aspiration is usually a major concern in the head and neck malignancy populace and reported a pattern towards more frequent aspiration post-(chemo)radiotherapy. Conclusion Overall the literature on thickened liquids as an intervention to eliminate aspiration in the head and neck malignancy population is limited. Because aspiration is known to be prevalent in the head and neck malignancy populace and thickened liquids are known to eliminate aspiration in other populations it is important to determine the effectiveness of thickened liquids for P7C3-A20 reducing aspiration in the head and neck malignancy population. Keywords: head and neck malignancy dysphagia aspiration thickened liquid pneumonia deglutition deglutition disorders Dysphagia (swallowing impairment) Rabbit Polyclonal to GPRC5A. is usually a common and debilitating consequence for patients who undergo radiation therapy for the treatment of head and neck cancer (HNC). Often individuals who undergo radiation therapy (RT) suffer from both acute P7C3-A20 and long-term swallowing complications(1). The long-term side effects that negatively impact swallowing not only impact the survivor actually but may contribute to decreased quality of life P7C3-A20 and decreased participation in everyday life(2). A variety of reviews have been conducted regarding swallowing outcomes in those treated with radiation and/or chemotherapy(3-6). Although multiple reviews have been conducted the literature still lacks specific information regarding the prevalence severity and management of aspiration (i.e. access of foreign material into the airway) following radiation therapy. Aspiration is a main concern when HNC patients present with dysphagia as it entails material passing through the vocal folds and entering the trachea. Penetration is a related event in which material enters the supraglottic space during videofluoroscopic assessment (VFSS) but is not observed to travel all the way below the vocal folds. Aspiration risk will be defined for the purposes of this review as a score of 3 or above around the Penetration-Aspiration Level(7). This is a widely-used level which classifies the severity of penetration-aspiration based on the depth of airway invasion and whether or not material is usually successfully ejected. Scores of 1 1 and 2 are seen in healthy people and reflect either complete absence of material entering the laryngeal vestibule or transient penetration of material into this area with subsequent ejection. Scores of 3 and higher are considered to reflect abnormal airway protection and indicate the presence of material in the supraglottic space or below without spontaneous clearing. Aspiration remains under-identified and under-reported in the head and neck malignancy population including those who have undergone RT(8 9 One reason why aspiration may not be apparent to patients and clinicians during non-instrumental assessment is the proven fact that RT may lead to sensory impairments in the tracheal area(8). Aspiration that is not sensed by the patient thereby leading to a lack of any overt physical response to the aspiration event (such as coughing or throat clearing) is known as ��silent aspiration��. Aspiration is usually dangerous to individuals who have undergone physically demanding treatments for malignancy and may lead to pneumonia and fatality(10). Although some may view aspiration as an acute toxicity of dysphagia research has also shown that chronic aspiration remains common up to one-year post-RT in head and neck patients(11). Many different interventions may be used to decrease the risk of aspiration while aiming to make swallowing less difficult and safer. These strategies include the P7C3-A20 implementation of postural changes modification of malignancy treatment techniques therapeutic exercises tailored radiation to spare important structures involved in swallowing and texture modification of liquids and foods(8). Thickened liquids are used to slow bolus circulation in the hopes of preventing aspiration and are widely thought to be effective.