Preoperative risk assessment for gastrostomy tube placement in head and neck cancer patients |
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Authors: | Schweinfurth J M Boger G N Feustel P J |
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Affiliation: | Division of Otolaryngology, Albany Medical Center, Albany, New York, USA. |
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Abstract: | BACKGROUND: The presentation and definitive surgical treatment of head and neck malignancies have varying impact on postoperative recovery and return of swallowing function, which heretofore has not been well defined. METHODS: We performed a retrospective chart review of 142 patients who underwent extirpative surgery for head and neck cancer. RESULTS: Factors significantly associated with the need for long-term postoperative nutritional support (p < .05) included heavy alcohol use, tongue base involvement and surgery, pharyngectomy, composite resection, reconstruction with a myocutaneous flap, radiation therapy, tumor size, and moderately-to-poorly differentiated histology. Heavy alcohol users were at an absolute risk for gastrostomy tube dependence; patients who underwent radiation therapy, flap reconstruction, tongue base resection, and pharyngectomy were at a two to sevenfold increased risk for gastrostomy tube dependence, respectively. CONCLUSIONS: High-risk patients based on these criteria should receive a feeding gastrostomy at the time of their initial surgical therapy. |
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Keywords: | head and neck cancer gastrostomy swallowing function nutrition video swallowing study |
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