CoDAS
http://www.codas.periodikos.com.br/article/doi/10.1590/2317-1782/e20240185pt
CoDAS
Artigo Original

Pressão de língua e autoavaliação da deglutição após laringectomia total

Tongue pressure and self-assessment of swallowing after total laryngectomy

Natália Carminati; Gracielle dos Santos David; Mariana Pinheiro Brendim

Downloads: 0
Views: 22

Resumo

RESUMO: Objetivo: Avaliar a pressão de língua, a autopercepção da deglutição e se existe correlação entre a pressão de língua e a autopercepção da deglutição em indivíduos submetidos à laringectomia total.

Método: Estudo transversal, constituído por dois grupos: com laringectomia total e sem laringectomia total (pareado por idade e sexo aos indivíduos com laringectomia total). Os participantes foram submetidos à mensuração da pressão de ponta e de dorso de língua; e à autoavaliação da deglutição, por meio do questionário Swallow Outcomes After Laryngectomy (SOAL).

Resultados: A amostra totalizou 26 participantes, sendo 13 de cada grupo. As médias da pressão máxima de dorso de língua foram 41,2±18,7 e 27,9±9,3 kilopascal, respectivamente, nos grupos com e sem laringectomia total (p=0,03). As medianas da pressão máxima de ponta de língua foram 33,7 (23,8-49,3) e 29,1 (22,5-35,7) kilopascal, respectivamente, nos grupos com e sem laringectomia total (p=0,29). A mediana do SOAL foi 6 (2,5-8,5) pontos no grupo com laringectomia total. Não houve correlação estatisticamente significativa entre a pontuação do SOAL e a pressão de ponta (r=-0,17; p=0,58) e de dorso (r=-0,30; p=0,31) de língua.

Conclusão: Indivíduos com laringectomia total apresentam maior pressão de dorso de língua, apesar de não haver diferença na pressão de ponta de língua entre indivíduos com e sem laringectomia total. Não há correlação entre a pressão de língua e a autoavaliação da deglutição, embora haja correlação entre a pressão de ponta e de dorso de língua de indivíduos com laringectomia total.

Palavras-chave

Laringectomia, Deglutição, Transtornos de Deglutição, Língua, Câncer de Cabeça e Pescoço, Disfagia

Abstract

Purpose: To evaluate tongue pressure, self-perception of swallowing, and whether tongue pressure is correlated with self-perception of swallowing in individuals undergoing total laryngectomy. Methods: Cross-sectional study with two groups – with and without total laryngectomy, matched by age and sex to individuals with total laryngectomy. Participants had their tongue tip and dorsum pressure measured and self-assessed their swallowing with the Swallow Outcomes After Laryngectomy questionnaire (SOAL). Results: The sample totaled 26 participants, 13 from each group. The mean maximum tongue dorsum pressure was 41.2±18.7 and 27.9±9.3 kilopascals, respectively, in the groups with and without total laryngectomy (p = 0.03). The median maximum tongue tip pressure was 33.7 (23.8-49.3) and 29.1 (22.5-35.7) kilopascals, respectively, in the groups with and without total laryngectomy (p = 0.29). The median SOAL was 6 (2.5-8.5) points in the group with total laryngectomy. The SOAL score was not statistically significantly correlated with tongue tip pressure (r = -0.17; p = 0.58) or dorsum pressure (r = -0.30; p = 0.31). Conclusion: Individuals with total laryngectomy had higher tongue dorsum pressure, although there was no difference in tongue tip pressure between individuals with and without total laryngectomy. Tongue pressure was not correlated with self-assessment of swallowing, although tongue tip pressure was correlated with dorsum pressure in individuals with total laryngectomy

Keywords

Laryngectomy; Swallowing; Swallowing Disorders; Tongue; Head and Neck Câncer; Dysphagia

Referências

1 Kouka M, Beckmann L, Bitter T, Kaftan H, Böger D, Büntzel J, et al. Oncological and functional outcome after laryngectomy for laryngeal and hypopharyngeal cancer: a population-based analysis in Germany from 2001 to 2020. Sci Rep. 2024;14(1):7761. http://doi.org/10.1038/s41598-024-58423-x. PMid:38565603.

2 Neijman M, Hilgers F, van den Brekel M, van Son R, Stuiver M, van der Molen L. Dysphagia after total laryngectomy: an exploratory study and clinical phase II rehabilitation trial with the Novel Swallowing Exercise Aid (SEA 2.0). Dysphagia. 2024;9(5):916-36. http://doi.org/10.1007/s00455-024-10673-7. PMid:38558177.

3 Maclean J, Cotton S, Perry A. Dysphagia following a total laryngectomy: the effect on quality of life, functioning, and psychological well-being. Dysphagia. 2009;24(3):314-21. http://doi.org/10.1007/s00455-009-9209-0. PMid:19290578.

4 Govender R, Lee MT, Drinnan M, Davies T, Twinn C, Hilari K. Psychometric evaluation of the Swallowing Outcomes After Laryngectomy (SOAL) patient-reported outcome measure. Head Neck. 2016;38(Suppl 1):E1639-45. http://doi.org/10.1002/hed.24291. PMid:26613682.

5 Queija DS, Portas JG, Dedivitis RA, Lehn CN, Barros APB. Swallowing and quality of life after total laryngectomy and pharyngolaryngectomy. Rev Bras Otorrinolaringol (Engl Ed). 2009;75(4):556-64. http://doi.org/10.1016/S1808-8694(15)30496-1. PMid:19784426.

6 Pernambuco LA, Oliveira JH, Régis RM, Lima LM, Araújo AM, Balata PM, et al. Quality of life and deglutition after total laryngectomy. Int Arch Otorhinolaryngol. 2012;16(4):460-5. http://doi.org/10.7162/S1809-97772012000400006. PMid:25991974.

7 Algave DP, Mourão LF. Qualidade de vida em laringectomizados totais: uma análise sobre diferentes instrumentos de avaliação. Rev CEFAC. 2015;17(1):58-70. http://doi.org/10.1590/1982-021620158413.

8 Anjos LMD, Silva FTMD, Pernambuco L. Translation and cross-cultural adaptation of the Swallow Outcomes After Laryngectomy (SOAL) Questionnaire for Brazilian Portuguese. CoDAS. 2021;33(4):e20200018. http://doi.org/10.1590/2317-1782/20202020018. PMid:34133613.

9 Sanguanchom M, Keskool P, Sureepong P, Ongard S. Assessing tongue strength and swallowing function following hyoid bone resection surgery. Ear Nose Throat J. 2023;22:1455613231191019. http://doi.org/10.1177/01455613231191019. PMid:37608452.

10 Ogawa A, Koganemaru S, Takahashi T, Takemura Y, Irisawa H, Goto K, et al. Swallow-related brain activity in post-total laryngectomy patients: a case series study. Prog Rehabil Med. 2023;8(0):20230026. http://doi.org/10.2490/prm.20230026. PMid:37663527.

11 Mcconnel FMS. Analysis of pressure generation and bolus transit during pharyngeal swallowing. Laryngoscope. 1988;98(1):71-8. http://doi.org/10.1288/00005537-198801000-00015. PMid:3336265.

12 Anjos LM, Ferreira TES, Pernambuco L. Biomecânica da língua durante a deglutição após laringectomia total: revisão integrativa. CoDAS. 2021;33(6):e20200102. http://doi.org/10.1590/2317-1782/20202020102. PMid:34190810.

13 Magalhães HV Jr, Pernambuco LA, Cavalcanti RVA, Silva RGD, Lima KC, Ferreira MAF. Accuracy of an epidemiological oropharyngeal dysphagia screening for older adults. Gerodontology. 2022;39(4):418-24. http://doi.org/10.1111/ger.12613. PMid:34913514.

14 Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86(8):1516-20. http://doi.org/10.1016/j.apmr.2004.11.049. PMid:16084801.

15 Magalhães HV Jr, Pernambuco LA, Cavalcanti RVA, Lima KC, Ferreira MAF. Validity evidence of an epidemiological oropharyngeal dysphagia screening questionnaire for older adults. Clinics (São Paulo). 2020;75:e1425. http://doi.org/10.6061/clinics/2020/e1425. PMid:31939561.

16 Ramos VF, Silva AF, Degan VV, Celeste LC, Picinato-Pirola M. Lip and tongue pressure and the functionality of oro-facial structures in healthy individuals. J Oral Rehabil. 2023;50(10):991-1001. http://doi.org/10.1111/joor.13531. PMid:37282365.

17 Dworkin JP, Hartman DE, Keith RL. Tongue strength Part I: following total laryngectomy. Laryngoscope. 1980;90(4):680-4. http://doi.org/10.1288/00005537-198004000-00017. PMid:7359988.

18 Doeltgen SH, Francis R, Daniels SK, Kaur H, Mohammadi L, Murray J. Behavioral interventions targeting base of tongue to posterior pharyngeal wall approximation: a scoping review. Dysphagia. 2023;38(3):768-84. http://doi.org/10.1007/s00455-022-10519-0. PMid:36163399.

19 Hartman DE, Dworkin JP, Keith RL. Tongue strength. Part II: in artificial alaryngeal speech. Laryngoscope. 1980;90(5 Pt 1):867-70. http://doi.org/10.1288/00005537-198005000-00019. PMid:7374318.

20 Govender R, Lee MT, Davies TC, Twinn CE, Katsoulis KL, Payten CL, et al. Development and preliminary validation of a patient-reported outcome measure for swallowing after total laryngectomy (SOAL questionnaire). Clin Otolaryngol. 2012;37(6):452-9. http://doi.org/10.1111/coa.12036. PMid:23039924.

21 Rahayu Rarasati R, Herawati Juniati S, Yusuf M. Conformity between modified Swallowing Outcome After Laryngectomy questionnaire and Flexible Endoscopic Evaluation of Swallowing in laryngeal carcinoma patients after total laryngectomy. J Public Health Res. 2022;11(4):22799036221127624. http://doi.org/10.1177/22799036221127624. PMid:36310823.

22 Maclean J, Szczesniak M, Cotton S, Cook I, Perry A. Impact of a laryngectomy and surgical closure technique on swallow biomechanics and dysphagia severity. Otolaryngol Head Neck Surg. 2011;144(1):21-8. http://doi.org/10.1177/0194599810390906. PMid:21493382.
 


Submetido em:
14/06/2024

Aceito em:
16/09/2024

680cf1c0a9539514504446e4 codas Articles

CoDAS

Share this page
Page Sections