TY - JOUR
T1 - Expert Consensus Statement
T2 - Management of Dysphagia in Head and Neck Cancer Patients
AU - Kuhn, Maggie A.
AU - Gillespie, M. Boyd
AU - Ishman, Stacey L.
AU - Ishii, Lisa E.
AU - Brody, Rebecca
AU - Cohen, Ezra
AU - Dhar, Shumon I.
AU - Hutcheson, Kate
AU - Jefferson, Gina
AU - Johnson, Felicia
AU - Rameau, Anais
AU - Sher, David
AU - Starmer, Heather
AU - Strohl, Madeleine
AU - Ulmer, Karen
AU - Vaitaitis, Vilija
AU - Begum, Sultana
AU - Batjargal, Misheelt
AU - Dhepyasuwan, Nui
N1 - Publisher Copyright:
© 2023 American Academy of Otolaryngology–Head and Neck Surgery Foundation.
PY - 2023/4
Y1 - 2023/4
N2 - Objective: To develop an expert consensus statement (ECS) on the management of dysphagia in head and neck cancer (HNC) patients to address controversies and offer opportunities for quality improvement. Dysphagia in HNC was defined as swallowing impairment in patients with cancers of the nasal cavity, paranasal sinuses, nasopharynx, oral cavity, oropharynx, larynx, or hypopharynx. Methods: Development group members with expertise in dysphagia followed established guidelines for developing ECS. A professional search strategist systematically reviewed the literature, and the best available evidence was used to compose consensus statements targeted at providers managing dysphagia in adult HNC populations. The development group prioritized topics where there was significant practice variation and topics that would improve the quality of HNC patient care if consensus were possible. Results: The development group identified 60 candidate consensus statements, based on 75 initial proposed topics and questions, that focused on addressing the following high yield topics: (1) risk factors, (2) screening, (3) evaluation, (4) prevention, (5) interventions, and (6) surveillance. After 2 iterations of the Delphi survey and the removal of duplicative statements, 48 statements met the standardized definition for consensus; 12 statements were designated as no consensus. Conclusion: Expert consensus was achieved for 48 statements pertaining to risk factors, screening, evaluation, prevention, intervention, and surveillance for dysphagia in HNC patients. Clinicians can use these statements to improve quality of care, inform policy and protocols, and appreciate areas where there is no consensus. Future research, ideally randomized controlled trials, is warranted to address additional controversies related to dysphagia in HNC patients.
AB - Objective: To develop an expert consensus statement (ECS) on the management of dysphagia in head and neck cancer (HNC) patients to address controversies and offer opportunities for quality improvement. Dysphagia in HNC was defined as swallowing impairment in patients with cancers of the nasal cavity, paranasal sinuses, nasopharynx, oral cavity, oropharynx, larynx, or hypopharynx. Methods: Development group members with expertise in dysphagia followed established guidelines for developing ECS. A professional search strategist systematically reviewed the literature, and the best available evidence was used to compose consensus statements targeted at providers managing dysphagia in adult HNC populations. The development group prioritized topics where there was significant practice variation and topics that would improve the quality of HNC patient care if consensus were possible. Results: The development group identified 60 candidate consensus statements, based on 75 initial proposed topics and questions, that focused on addressing the following high yield topics: (1) risk factors, (2) screening, (3) evaluation, (4) prevention, (5) interventions, and (6) surveillance. After 2 iterations of the Delphi survey and the removal of duplicative statements, 48 statements met the standardized definition for consensus; 12 statements were designated as no consensus. Conclusion: Expert consensus was achieved for 48 statements pertaining to risk factors, screening, evaluation, prevention, intervention, and surveillance for dysphagia in HNC patients. Clinicians can use these statements to improve quality of care, inform policy and protocols, and appreciate areas where there is no consensus. Future research, ideally randomized controlled trials, is warranted to address additional controversies related to dysphagia in HNC patients.
KW - dysphagia
KW - head and neck cancer
KW - laryngeal cancer
KW - nasopharyngeal cancer
KW - oral cavity cancer
KW - oropharyngeal cancer
KW - radiation
KW - swallowing
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U2 - 10.1002/ohn.302
DO - 10.1002/ohn.302
M3 - Article
C2 - 36965195
AN - SCOPUS:85150837495
SN - 0194-5998
VL - 168
SP - 571
EP - 592
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 4
ER -