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Pharyngeal Residue Measurements in Patients Treated with Chemoradiation for Head and Neck Cancer

Rozynek, Lindsay (2019) Pharyngeal Residue Measurements in Patients Treated with Chemoradiation for Head and Neck Cancer. Master's Thesis, University of Pittsburgh. (Unpublished)

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Difficulty swallowing is a common consequence of individuals who are treated with primary radiation therapy (RT) or primary radiation therapy with chemotherapy (CRT) for head and neck cancer (HNC). Exercise programs are often utilized to maintain or improve function during and following RT/CRT for HNC. One component of dysphagia in people treated with RT/CRT for HNC is the retention of pharyngeal residue after swallows due to impaired clearance caused by these structural/tissue RT/CRT changes. Pharyngeal residue is measured from imaging studies using subjective and more objective methods that seek to quantify residue and indicate the level of impairment.
We sought to characterize pharyngeal residue using the Normalized Residue Ratio Scale (NRRS) described by Pearson, Molfenter, Smith, and Steele (2013). The study was done retrospectively with secondary data, collected between January 7, 2016 and June 29, 2016. Participants were patients treated with CRT for HNC and received 8 weeks of exercise therapy using either instrument-guided or non-instrument-guided protocol. The results of the residue ratings pre- and post-therapy were compared using the NRRS and number of swallows per bolus. Based on observations during pre-data analysis, we proposed a variant of the NRRS which we deployed in a second analysis to determine whether NRRS may overestimate pharyngeal residue.
Due to use of secondary data, a significant number of pairs for pre- and post-treatment data were unavailable. We performed descriptive analyses for pre- and post-treatment NRRS scores and for pre- and post-treatment number of swallows per bolus. We are unable to offer results for pre- and post-treatment and number of swallows per bolus that offer information that would generalize to a wider sample outside of our study. We found the frame selected for measurements based on the published NRRS methods led to significantly higher residue ratio scores in the valleculae but not in the piriform sinuses, compared to our NRRS variant method of frame selection.
The results of our study suggest evidence that the NRRS may overestimate residue in the valleculae but not the piriform sinuses. Larger scale research is warranted to determine if these results generate to the overall construct of residue measurements.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCoyle,
Committee MemberShaiman,
Committee MemberMatthews,
Committee MemberBrown,
Date: 4 June 2019
Date Type: Publication
Defense Date: 4 March 2019
Approval Date: 4 June 2019
Submission Date: 25 April 2019
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 53
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Communication Science and Disorders
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Residue, Normalized Residue Ratio Scale, Dysphagia
Date Deposited: 04 Jun 2019 19:23
Last Modified: 04 Jun 2019 19:23


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