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Published on: February 2, 2020
Prevalence of Self-Reported Oropharyngeal Dysphagia and Associated Factors in Iranian Patients With Head and Neck
Fardin Sharifi1, Behnaz Bayat2, Samira Azghandi3
1University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Introduction:
Dysphagia is a common complication in patients with head and neck cancer (HNC), primarily due to the tumour location and the adverse effects of treatment, which significantly diminish patients' quality of life (QOL).
Objective:
This study aimed to assess the prevalence of self-reported oropharyngeal dysphagia and identify associated factors in Iranian patients diagnosed with HNC.
Methods:
Out of an initial cohort of 142 HNC patients, 113 completed the Eating Assessment Tool (EAT-10), and 90 completed the Persian version of the MD Anderson Dysphagia Inventory (P-MDADI) to evaluate dysphagia prevalence and its impact on QOL. Associations between demographic variables and dysphagia duration were analysed using chi-square tests and Kendall's Tau correlation.
Results:
Among the 113 patients with HNC (mean age 55.95 years, SD 14.78; 61.1% male), 78.8% reported dysphagia (95% CI, 71.10-86.41%). Dysphagia prevalence was highest in patients with tumours in the oral cavity (85.7%), pharynx (91.3%), larynx (70%), and sinus/nose (52.9%). Significant correlations were observed between EAT-10 scores, tumour site, and dysphagia duration (p < 0.05). P-MDADI scores indicated substantial emotional (92% reported feeling "self-conscious"), physical (91% noted "prolonged eating"), and functional challenges, underscoring dysphagia's profound impact on QOL.
Conclusion:
This study demonstrates a high prevalence of dysphagia among Iranian HNC patients, with marked variation by tumour site and dysphagia duration. P-MDADI findings underscore the substantial impact of dysphagia on QOL, affecting patients functionally, physically, and emotionally.
What This Paper Adds:
What is already known on the subject Oropharyngeal dysphagia (swallowing dysfunction) is a common consequence in patients with head and neck cancer (HNC). The presence of dysphagia leads to malnutrition, dehydration and reduced quality of life in these patients. Although the prevalence of dysphagia has been studied in various countries worldwide, there is no evidence specifically addressing Iranian patients with HNCs. What this paper adds to the existing knowledge The results of this study indicate the first prevalence estimates of self-reported dysphagia among Iranian patients with HNC. It recognizes demographic and clinical factors associated with dysphagia risk (tumour location and duration) and emphasizes the importance of patient-reported outcomes in complementing traditional clinical evaluations. What are the potential or actual clinical implications of this work? Routine screening for dysphagia using patient-reported measures such as MD Anderson Dysphagia Inventory (MDADI) can improve early diagnosis and proper management in Iranian speech therapy and oncology clinics. The findings support multidisciplinary management and may guide healthcare and rehabilitation programs appropriate to the cultural and clinical needs of patients with HNCs.
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