Effects of personalized swallowing rehabilitation in patients with oral cancer after free flap transplantation: A cluster randomized controlled trial

Oral Oncol. 2022 Nov:134:106097. doi: 10.1016/j.oraloncology.2022.106097. Epub 2022 Sep 18.

Abstract

Objectives: Dysphagia is a common and serious complication in patients with oral cancer after free flap transplantation (OC-FFT), which seriously affects their quality of life. Studies have found swallowing rehabilitation can improve the swallowing ability of these patients, but the studies have design deficiencies. This study's purpose was to test the effectiveness of personalized swallowing rehabilitation for this patient population.

Materials and methods: This is a cluster randomized, non-blind, controlled clinical trial. Participants were 68 OC-FFT patients randomly assigned to intervention (n = 34) or control (n = 34) groups. The control group received routine nursing and health education, while the intervention group received personalized swallowing rehabilitation twice a day for 10 days, based on the results of the Mann Assessment of Swallowing Ability-Oral Cancer (MASA-OC). On the 6th and 15th days and 1 month after the operation, MASA-OC scores and percentage weight loss were measured, and the removal time to nasogastric tube was also recorded. The quality of life was evaluated 1 month after the operation.

Results: On day 15 and 1 month after the operation, MASA-OC scores were higher and the percentage weight loss was lower in the intervention group than the control group (P < 0.05). The removal time of the nasogastric tube was shorter (P < 0.05), and the quality of life at 1 month was better in the intervention group (P < 0.05).

Conclusion: Personalized swallowing rehabilitation can improve patients' swallowing after OC-FFT, promote the early removal of the nasogastric tube, and improve nutritional status and quality of life.

Keywords: Dysphagia; Free flap; Oral cancer; Personalized swallowing rehabilitation; Quality of life; Randomized controlled trial; Swallowing.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Deglutition
  • Deglutition Disorders* / etiology
  • Deglutition Disorders* / rehabilitation
  • Deglutition Disorders* / surgery
  • Free Tissue Flaps*
  • Humans
  • Mouth Neoplasms* / complications
  • Mouth Neoplasms* / surgery
  • Quality of Life
  • Treatment Outcome
  • Weight Loss