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Head Neck. 2019 Jul;41(7):2051-2057. doi: 10.1002/hed.25656. Epub 2019 Jan 30.

Assessing functional outcomes in head and neck surgical oncology.

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Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
Department of Speech, Language and Swallowing Disorders, Massachusetts General Hospital, Boston, Massachusetts.
Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.



A reliable method of measuring functional outcomes is essential to inform treatment decisions in head and neck cancer.


Members of the American Head and Neck Society were surveyed regarding their use of functional outcome assessment tools. Qualitative statistical analysis was performed to identify major tools used and to clarify obstacles to functional outcome assessment. A comprehensive literature review was performed to identify available tools.


A total of 142 surgeons were surveyed. 44.12% of respondents use at least 1 tool to assess functional outcomes. The most frequently used tools were modified barium swallow, MD Anderson Dysphagia Inventory, and functional endoscopic evaluation of swallow (FEES). 72.65% of respondents reported barriers to assessment, most frequently a lack of support to administer the tests or to collect, apply or analyze the results. Review of the literature revealed 173 available tools.


Although a wide variety of validated tools are available in the literature to assess functional outcomes after head and neck surgery, major obstacles to their use persist. The lack of a standard measure that is practical and transferable continues to impair research progression in this field.


function; functional outcome; head and neck cancer; head and neck oncology; quality of life; speech; swallow


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