Objectives: Investigate the feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing (FEES) following a programme of prophylactic swallowing exercises in head and neck cancer (HNC) patients treated with radiotherapy.
Design: Prospective, single cohort, feasibility study.
Setting: Three head and neck cancer centres in Scotland.
Participants: Pre-radiotherapy HNC patients who consented to participate in a prophylactic swallowing intervention.
Outcome measures: Fibreoptic endoscopic evaluation of swallowing recruitment and retention rates, assessment acceptability and compliance, qualitative process evaluation.
Results: Higher rates of recruitment and retention were achieved in centres where FEES equipment was available on-site. Travel and anticipated discomfort were barriers to recruitment. Data completion was high for all rating scales, with good reliability. Following radiotherapy, swallowing safety significantly deteriorated for liquid boluses (P = 0.005-0.03); pharyngeal residue increased for liquid and semi-solid boluses. Pharyngo-laryngeal oedema was present pre-treatment and significantly increased post-radiotherapy (P = 0.001). Patients generally reported positive experience of FEES for their own learning and establishing a baseline.
Conclusions: Fibreoptic endoscopic evaluation of swallowing is an acceptable method of assessing patients for a prophylactic swallowing intervention and offers some additional information missing from VF. Barriers have been identified and should be taken into account in order to maximise recruitment for future trials.
Keywords: dysphagia; feasibility; fibreoptic endoscopic evaluation of swallowing; head and neck cancer; intervention; radiotherapy; rehabilitation.
© 2019 John Wiley & Sons Ltd.