Survey of usual practice: dysphagia therapy in head and neck cancer patients

Gintas P Krisciunas, William Sokoloff, Katherine Stepas, Susan E Langmore, Gintas P Krisciunas, William Sokoloff, Katherine Stepas, Susan E Langmore

Abstract

There is no standardized dysphagia therapy for head and neck cancer patients and scant evidence to support any particular protocol, leaving institutions and individual speech-language pathologists (SLPs) to determine their own protocols based on "typical" practices or anecdotal evidence. To gain an understanding of current usual practices, a national internet-based survey was developed and disseminated to SLPs who treat head and neck cancer (HNC) patients. From a random sample of 4,000 ASHA SID13 members, 1,931 fit the inclusion criteria, and 759 complete responses were recorded for a 39.3 % response rate. Results were analyzed by institution type as well as by individual clinical experience. While some interesting trends emerged from the data, a lack of uniformity and consensus regarding best practices was apparent. This is undoubtedly due to a paucity of research adequately addressing the efficacy of any one therapy for dysphagia in the HNC population.

Figures

Figure 1
Figure 1
Treatment recommendations for patients during RT. (N=752)
Figure 2
Figure 2
Treatment recommendations after RT for patients with mild or clinically insignificant dysphagia. (N=745)
Figure 3
Figure 3
Treatment recommendations after RT for patients with moderate to severe dysphagia. (N=738) recommended for patients during RT. (N=728)
Figure 4
Figure 4
Frequency of home therapy programs recommended for patients during RT. (N=728)
Figure 5
Figure 5
Intensity of home therapy programs recommended for patients during RT. (N=728)
Figure 6
Figure 6
Frequency of home therapy programs recommended for patients following recommended for patients without dysphagia following RT. (N=723)
Figure 7
Figure 7
Intensity of home therapy programs recommended for patients without dysphagia following RT. (N=723)
Figure 8
Figure 8
Frequency of home therapy programs recommended for patients with dysphagia following RT. (N=737)
Figure 9
Figure 9
Intensity of home therapy programs recommended for patients with dysphagia following RT. (N=737)
Figure 10
Figure 10
SLPs recommendations for PEG use among HNC patients who receive a prophylactic PEG. (N=722) .

Source: PubMed

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