English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Malnutrition is a common problem in head and neck cancer with up to 50% of the patients developing some degree of nutritional deficiency.1 The etiologies of this problem can be divided into two categories: tumor related or treatment related. Patient with tumor related malnutrition typically present with obvious clinical signs and symptoms of undernourishment. Tumor cachexia can contribute but this is primarily caused by physical impediments to oral consumption such as pain, oropharygeal obstruction, or nerve compression , all resulting in discordant degluttination.2 Prior to definitive cancer therapy, this group of patients requires nutritional resuscitation. Additionally many patients who present nutritionally sound and who undergo surgical resection experience some degree of postoperative nutritional difficulties. In many cases it a short lived and inconsequential. However, a subset of patients will experience a more severe prolonged course requiring enteral supplementation. Prior studies have shown that if these patients are not supplemented, they will likely experience severe dehydration, treatment intolerance, or severe treatment related complications that require hospitalization.3,4 Inherently, the surgical treatment of head and neck malignancies can be quite debilitating and result in significant mastication and deglutination dysfunction.5-7 At times this involves radical resections that require complex reconstructions to maintain oropharyngeal continuity; and adjuvant radiation and/or chemotherapy may be required to maximize local control. Indiscriminately placing PEG tubes in all patients would put many patients at risk for PEG related complications.8-13 Therefore, the difficulty has been trying to preoperatively identify which patients likely to experience prolonged treatment induced malnutrition and benefit from early nutritional supplementation. Groups have identified some factors that are predictive of a need for enteral support.3,4,14-17 One factor that has been clearly established is radiation therapy, particular when given

Defining the Indications for Prophylactic Percutaneous Endoscopic Gastrostomy Tubes in Surgically Treated Head and Neck Cancer Patients