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Reflex vs. volitional cough differences amongst head and neck cancer survivors characterized by time since treatment and aspiration status
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2021-05-24 , DOI: 10.1016/j.resp.2021.103702
Amy Fullerton 1 , Yuhan Mou 2 , Natalie Silver 3 , Neil N Chheda 4 , Kathryn Hitchcock 5 , Karen Hegland 6
Affiliation  

Background

The aim of this study was to investigate differences in reflexive and volitional cough airflows in advanced stage head and neck cancer survivors as it relates to aspiration status and time since treatment. The hypothesis is that those who aspirate several years after treatment completion would demonstrate reduced airflows for all cough parameters compared to those recently status post treatment completion given the known progressive deterioration associated with radiotherapy.

Methods

Demographic and airflow data during both reflexive and volitional cough tasks and aspiration status as determined during fiberoptic endoscopic evaluation of swallow function were collected from 33 Head and Neck Cancer (HNC) survivors.

Results

Omnibus MANOVA for dependent airflow variables and independent variables aspiration status, time since treatment and cough type (reflex or volitional) was significant (F(3,1) = 184, p < 0.000) indicating that peak expiratory flow rates (PEFR) were reduced under reflex (mean PEFR 1.88 SD 0.7) versus volitional (mean PEFR 2.3, SD 0.7) cough types; reduced for aspirators versus non-aspirators (F(2,1) = 4.1, p = 0.04) and reduced for those in the subacute versus chronic phase status post Intensity Modulated Radiotherapy (IMRT) (F(2,1) = 10.05, p = 0.002).

Conclusion

Findings of reduced reflexive compared to volitional cough airflows in head and neck cancer survivors are consistent with those from both healthy and other diseased populations. Additional findings that aspirators demonstrate reduced cough airflows compared to non-aspirators supports the hypothesis. Surprisingly, those recently status post treatment completion show worse cough airflows compared to those remotely status post treatment completion.



中文翻译:

头颈癌幸存者反射性咳嗽与自主性咳嗽的差异,以治疗后的时间和误吸状态为特征

背景

本研究的目的是调查晚期头颈癌幸存者的反射性和自主性咳嗽气流的差异,因为它与吸入状态和治疗后的时间有关。假设是,鉴于已知与放射治疗相关的进行性恶化,与最近完成治疗后的状态相比,那些在治疗完成后数年进行抽吸的人将表现出所有咳嗽参数的气流减少。

方法

从 33 名头颈癌 (HNC) 幸存者收集反射性和自主性咳嗽任务期间的人口统计和气流数据,以及在纤维内窥镜下评估吞咽功能期间确定的吸入状态。

结果

因气流变量和自变量吸入状态、自治疗后的时间和咳嗽类型(反射性或意志性)的综合 MANOVA 显着(F(3,1) = 184, p  < 0.000),表明呼气峰值流速 (PEFR) 降低反射下(平均 PEFR 1.88 SD 0.7)与意志(平均 PEFR 2.3,SD 0.7)咳嗽类型;吸气器与非吸气器相比降低 (F(2,1) = 4.1, p  = 0.04),调强放疗 (IMRT) 后处于亚急性期与慢性期的患者降低 (F(2,1) = 10.05, p  = 0.002)。

结论

与健康和其他患病人群相比,头颈癌幸存者的反射性减少与自主咳嗽气流相比的发现是一致的。与非吸气器相比,吸气器表现出减少咳嗽气流的其他发现支持了这一假设。令人惊讶的是,与那些在治疗完成后的远程状态相比,那些最近完成治疗后的状态显示出更差的咳嗽气流。

更新日期:2021-07-01
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