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Doctoral Thesis
DOI
https://doi.org/10.11606/T.25.2020.tde-05102021-115010
Document
Author
Full name
Danila Rodrigues Costa
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2020
Supervisor
Committee
Berretin, Giédre (President)
Guedes, Renata Lígia Vieira
Sanchez, Renata Furia
Santos, Paulo Sergio da Silva
Title in Portuguese
Sintomas de disfagia orofaríngea, eficiência e segurança da deglutição em pacientes após o tratamento do câncer de cabeça e pescoço
Keywords in Portuguese
Neoplasias de cabeça e pescoço
Quimioterapia
Radioterapia
Transtornos da deglutição
Abstract in Portuguese
Os indivíduos submetidos ao tratamento do câncer de cabeça e pescoço podem apresentar uma menor consciência e percepção de sintomas específicos da disfagia, sendo necessário distinguir entre sintomas de disfagia e evidência objetiva de disfunção da deglutição. Este trabalho tem por objetivo verificar a relação entre sintomas e sinais de disfagia orofaríngea em indivíduos após tratamento do câncer de cabeça e pescoço. Para isso foi realizado um estudo retrospectivo observacional transversal analítico que incluiu 32 pacientes adultos e idosos acometidos pelo câncer de cabeça e pescoço. Foram analisados os dados do protocolo Eating Assessment Tool (EAT-10), que verifica os sintomas de disfagia orofaríngea, assim como dos exames de videofluoroscopia da deglutição. A partir do exame de videofluoroscopia foi classificado o grau da disfagia orofaríngea, bem como a segurança e eficiência da deglutição por meio da escala DIGEST (Dynamic Imaging Grade of Swallowing Toxicity). Os dados encontrados foram submetidos ao teste de correlação de Pearson, adotando nível de significância de 5%. Os resultados demonstraram que houve correlação significativa entre os escores DIGEST com o perfil de eficiência (p= 0,000) e com o perfil de segurança (p=0,011), assim como entre a pergunta 2 do EAT-10 (meu problema para engolir não me deixa comer fora de casa) (p= 0,026) e o perfil de eficiência da deglutição. Não foi encontrada relação significativa entre o escore DIGEST com o escore EAT-10 (p=0,464) e nem mesmo entre o escore EAT-10 e a eficiência (p=0,255) ou a segurança (p=0,927). Diante desses achados, concluiu-se que não houve relação entre a maioria dos sintomas e sinais de disfagia orofaríngea em pacientes após o tratamento do câncer de cabeça e pescoço, a médio e longo prazo, demonstrando que a percepção do paciente sobre a função de deglutição pode não ser consistente com os achados da avaliação instrumental nessa população.
Title in English
Symptoms of oropharyngeal dysphalgia, efficiency and safety of swallowing in patients after treatment of head and neck cancer
Keywords in English
Chemotherapy
Head and neck neoplasms
Radiotherapy.
Swallowing disorders
Abstract in English
Individuals undergoing head and neck cancer treatment may have less awareness and perception of specific dysphagia symptoms, and it is necessary to distinguish between symptoms of dysphagia and objective evidence of swallowing dysfunction. This work aims to verify the relationship between symptoms and signs of oropharyngeal dysphagia in individuals after treatment of head and neck cancer. For this, a retrospective observational cross-sectional analytical study was carried out that included 32 adult and elderly patients affected by head and neck cancer. Data from the Eating Assessment Tool (EAT-10) protocol, which verifies the symptoms of oropharyngeal dysphagia, as well as from the swallowing videofluoroscopy exams, were analyzed. From the videofluoroscopy exam, the degree of oropharyngeal dysphagia was classified, as well as the safety and efficiency of swallowing using the DIGEST scale (Dynamic Imaging Grade of Swallowing Toxicity). The data found were submitted to Pearson's correlation test, adopting a significance level of 5%. The results showed that there was a significant correlation between the DIGEST scores with the efficiency profile (p = 0.000) and with the safety profile (p = 0.011), as well as between question 2 of the EAT-10 (my problem with swallowing does not let me eat out) (p = 0.026) and the swallowing efficiency profile. No significant relationship was found between the DIGEST score and the EAT-10 score (p = 0.464) and not even between the EAT-10 score and efficiency (p = 0.255) or safety (p = 0.927). Given these findings, it was concluded that there was no relationship between most symptoms and signs of oropharyngeal dysphagia in patients after treatment of head and neck cancer, in the medium and long term, demonstrating that the patient's perception of the swallowing function may not be consistent with the findings of instrumental assessment in this population.
 
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Publishing Date
2021-10-05
 
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