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Feasibility and potential value of lipofilling in post‐treatment oropharyngeal dysfunction
Author(s) -
Kraaijenga Sophie A. C.,
Lapid Oren,
van der Molen Lisette,
Hilgers Frans J. M.,
Smeele Ludwig E.,
van den Brekel Michiel W. M.
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26003
Subject(s) - medicine , swallowing , dysphagia , surgery , head and neck cancer , quality of life (healthcare) , prospective cohort study , radiation therapy , nursing
Objectives/Hypothesis Head and neck cancer (HNC) patients may develop oropharyngeal dysfunction as result of volume loss or muscle atrophy of the tongue or pharyngeal musculature following treatment with surgery and/or chemoradiotherapy. If intensive swallowing therapy offers no further improvement, and the functional problems persist, transplantation of autologous adipose tissue (lipofilling) might restore functional outcomes by compensating the existing tissue defects or tissue loss. Study Design Case series. Methods In this prospective pilot feasibility study, the application of lipofilling was studied in seven HNC patients with chronic dysphagia. The procedure was carried out under general anesthesia in several sessions using the Coleman technique. Swallowing outcomes were evaluated with standard videofluoroscopy (VFS) for obtaining objective Penetration Aspiration Scale (PAS) and residue scores. Subjective Functional Oral Intake Scale scores and Swallowing Quality of Life Questionnaire were also completed. Magnetic resonance imaging was used to evaluate the post‐treatment injected fat. Results Five patients completed the intended three lipofilling sessions, whereas two completed two injections. One patient dropped out of the study after two injections because of progressive dysphagia requiring total laryngectomy. Four of the six remaining patients showed improved PAS scores on post‐treatment VFS assessments, with two patients no longer showing aspiration for a specific consistency. Two patients were no longer feeding tube dependent. Patient‐reported swallowing and oral intake improved in four out of six patients. Conclusions Based on the results, the lipofilling technique seems safe and, in selected cases, of potential value for improving swallowing function in this small therapy‐refractory HNC patient cohort. Level of Evidence 4 Laryngoscope , 126:2672–2678, 2016