Intervention of language therapy in the alterations of deglutition and voice in patients with head and neck cancer

Abstract

Introduction: in Costa Rica, the incidence rate of head and neck cancer for 2016 was of 68,3%, with a mortality rate of 25,4%. This type of cancer originates in the airways, thyroid and, salivary glands, and generates significant disturbances in swallowing and the production of the voice. The following work seeks to define the speech therapist’s intervention in swallowing and speech disturbances in patients with head and neck cancer.  Methodology: a bibliographical review was carried out based on review articles written in English and Spanish and books, published from 2000 to 2019. Experts point of view was recollected, for example, speech therapists who had worked in the intervention of patients with head and neck cancer. The bases used were PubMed, Medline, Santa Paula University’s Library; the descriptors used were head and neck cancer, OR cancer treatment OR chemotherapy OR radiotherapy AND dysphagia OR disturbances in voice OR phonation OR deglution OR breathing OR vocal cords AND therapy. A total of 25 articles were revised, and 11 were included that complied with the terms of inclusion.  Results: according to the opinions of the speech therapists in Costa Rica, the techniques used in the intervention of swallowing disturbances are compensatory techniques (postural maneuvers, modification of consistency, modification of volume and speed of presentation of the bolus) and rehabilitative techniques (swallowing maneuvers, exercises specifically for the orofacial mobility, facilitation techniques, and myofunctional therapy).  For speech disturbances, techniques like vocal hygiene, vocal work and the postural maneuvers are used.  Conclusion: in Costa Rica, the quantity of head and neck cancer cases is equivalent to 3,5% of the male population and 12% of the female population. These patients generally receive medical treatment, which can have secondary effects that cause disturbances in communication, breathing, and swallowing. The speech therapist fulfills a key function for survivors of head and neck cancer, as it identifies and rehabilitates the disturbances in communication, breathing, and swallowing caused by the pathology or its treatment, with the use of compensatory and rehabilitative techniques, methods for vocal hygiene, vocal work, and postural maneuvers.