Swallowing-related quality of life after free flap surgery due to cancer of the head and neck

Eur Arch Otorhinolaryngol. 2019 Mar;276(3):821-826. doi: 10.1007/s00405-018-05264-w. Epub 2018 Dec 28.

Abstract

Purpose: Treatment of head and neck cancers (HNC) often leads to impairment in speech and swallowing functions. This study evaluated swallowing problems and the impact of complications on swallowing-related QOL after free flap surgery for HNC.

Methods: Swallowing-related QOL was assessed using MDADI and SWAL questionnaires.

Results: Of 45 assessed patients, 25 (45.5%) had at least one postoperative complication. Patients reported less than < 86 points in 8/9 SWAL-QOL domains. The SWAL-QL total score or MDADI composite scores were not related to surgical complications. Those with medical complications had lower scores in SWAL-QOL domains of mental health (82.8 (21.8) vs 65.5 (24.2), p = 0.024) and sleep (77.6 (23.0) vs 52.3 (24.3), p = 0.003).

Conclusions: In conclusion, swallowing related QOL is significantly impaired after 2 years of the tumor resection and free flap reconstruction for cancer of the head and neck, when using the cut-off value of 86 points in SWAL-QOL assessment tool. Surgical complications did not have an impact on swallowing-related QOL but medical complications were related to impairment in general QOL-related domains.

Keywords: Cancer of the head and neck; Dysphagia; Free flap surgery; Quality of life.

MeSH terms

  • Aged
  • Deglutition Disorders / etiology*
  • Deglutition*
  • Female
  • Free Tissue Flaps
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Postoperative Complications / physiopathology
  • Quality of Life*
  • Speech
  • Surveys and Questionnaires