Avaliação endoscópica da deglutinação e qualidade de vida pré-pós tratamento do câncer de cabeça e pescoço

Abstract

Head and neck tumors have a higher incidence in the upper aerodigestive tracts, especially the oral cavity, oropharynx and larynx, which are structures closely related to swallowing. Due to this anatomofunctional relationship, the individual affected by the disease may have different degrees of swallowing disorders, even before the start of treatment. The Literature points out that more than half of these patients have dysphagia, especially, those with advanced disease. Dysphagia can bring functional limitations related to food safety, hydration and nutritional deficiency, as well as, impairing the quality of life in aspects: emotional, physical and social. OBJECTIVE: To evaluate the function of swallowing in patients with malignant neoplasms of the head and neck, and the perception of quality of life related to swallowing, before and after cancer treatment. METHODS: Observational, longitudinal study with 29 patients with malignant neoplasms of the head and neck, including histological diagnoses of squamous cell carcinoma of the head and neck, oral cavity, oropharynx, hypopharynx and larynx, with indication for radiotherapy. The swallowing evaluation was carried out before and after treatment, using videoendoscopy of swallowing (VED) and, to analyze the patient's perception of swallowing; the dysphagia questionnaire M. D. Anderson Dysphagia Inventory (MDADI) was applied. RESULTS: The most common primary tumor site of the patients was the larynx (41.4%), followed by the oral cavity (24.1%) and oropharynx (24.1%), with less occurrence of hypopharyngeal tumors (10. 3%). In relation to clinical staging, most patients were classified as major tumors T4 (34.5%) and T3 (17.2%). There was a worsening of the swallowing function after radiotherapy, with an increase in the frequency of penetration, aspiration and the severity of pharyngeal residues. The quality of life related to swallowing also varied, with the impact being minimal before treatment and medium after treatment. CONCLUSION: Dysphagia is present in head and neck cancer before treatment with worsening of its frequency of severity after spinal chemotherapy with an impact on the patients´ quality of life.