Correlation of Pharyngeal Residue with PenetrationAspiration in Post-Radiotherapy Nasopharyngeal Carcinoma Patients with Oropharyngeal Dysphagia

Abstract

Background: Nasopharyngeal carcinoma (NPC) ranks first for head and neck malignancies, and radiotherapy
is a recommended treatment. Most post-radiotherapy NPC patients experience oropharyngeal dysphagia that
results in pharyngeal residue. Pharyngeal residue is thought to be a risk factor for aspiration-penetration.
Objective: Examining the correlation between pharyngeal residue and penetration-aspiration in postradiotherapy NPC patients.
Method: Participants have been identified since 2018 to find out the total number of NPC patients. In
the period January-October 2019, identification of NPC patients was performed according to participant
criteria. Participants were examined for fiberoptic endoscopic evaluation of swallowing (FEES), pharyngeal
residue using the Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS), and penetration-aspiration
using Penetration-Aspiration Scale (PAS). Statistical tests were used Spearman correlation test with p<0.05.
Results: The highest participant’s pharyngeal residue appeared in vallecula when given soft bolus (96.55%),
and in pyriform sinus when given thick liquid bolus (72.41%). Most participants with soft bolus had the
highest negative penetration (72.59%) and positive penetration in thick liquid bolus (51.72%), while most
had negative aspirations with the lowest value (89.66%). There is aspiration in 10.34% of patients when
given a dilute liquid. There was a significant correlation between pharyngeal residue in vallecula and
pyriform sinus with penetration-aspiration (p<0.05). There was a positive association with the use of soft
bolus (r=0.623), thick liquid bolus (r=0.631), and dilute liquid bolus (r=0.891).
Conclusions: There is a significant association between pharyngeal residue and penetration-aspiration in
post-radiotherapy NPC patients.