Dysphagia in head and neck cancer patients with evidence of esophageal dysmotility on manometry

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-02-16 DOI:10.1016/j.oraloncology.2025.107219

Molly O. Meeker, BS , Akhil Katragadda , Mohammad Bilal Alsavaf , Jack Birkenbeuel , Zachary Wykoff , Songzhu Zhao , Apoorva T. Ramaswamy

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引用次数: 0

Abstract

Objectives

Dysphagia is a well-known complication of head and neck cancer (HNC) treatment that significantly impacts daily life for survivors. This study aims to characterize esophageal dysmotility identified on high resolution manometry (HRM) in HNC survivors with dysphagia.

Methods

A retrospective chart review of 30 patients who underwent HRM treated for dysphagia between August 1st 2020 to February 2nd, 2023, was conducted. Patients with dysphagia, at least one HRM, and treated in a HNC dysphagia clinic were included. HRM reports were analyzed using Chicago Classification Version 4.0 (CCV4). EGJ outflow obstruction (EGJOO) was validated using endoscopy or radiographic findings. Data was summarized using mean for continuous variables and frequencies for categorical variables.

Results

Of the 30 patients included in our study, 18 (60.0 %) showed evidence of CCV4 dysmotility. The most common subtypes were found to be ineffective motility (n = 6, 33.3 %), followed by EGJOO (n = 5, 27.8 %). Absent contractility and hypercontractile esophagus showed the same frequency (n = 3, 16.7 %), as did achalasia type 1 and type 2 (n = 1, 5.6 %).

Conclusion

Oropharyngeal and pharyngoesophageal dysphagia are well recognized causes of dysphagia, while esophageal dysmotility is an understudied cause of dysphagia in the HNC population. In this study of patients undergoing HRM for workup of their dysphagia after HNC, 60% had evidence of a CCV4 motility disorder, with the most common subtypes being ineffective motility and EGJOO. Therefore, HRM, the gold standard of diagnosis for esophageal dysmotility, should be considered in HNC patients who have symptoms suspicious for dysmotility.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.