Patient-Reported Dysphagia After Multimodal Therapy and Radial Forearm Free-Flap Reconstruction for OPSCC: Associations With FEES Findings, Psychological Distress, and Xerostomia.
- 1Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Hagen University of Witten/Herdecke Hagen Germany.
- 2Department of Otorhinolaryngology, Head and Neck Surgery Hospitals of the City of Cologne Cologne Germany.
- 3Department of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital Ruhr University Bochum Bochum Germany.
Abstract
Objective
This study investigated whether fiberoptic endoscopic evaluation of swallowing (FEES)-derived parameters reflect patient-reported dysphagia and swallowing-related quality of life in patients with oropharyngeal squamous cell carcinoma (OPSCC) after surgery-based multimodal therapy with free-flap reconstruction. In addition, it assessed the roles of psychological distress and xerostomia in this context.Methods
This multicenter, cross-sectional exploratory study included 50 patients. FEES parameters comprised Penetration-Aspiration Scale (PAS) and residue scores. Patient-reported outcomes were assessed using the Sydney Swallow Questionnaire (SSQ) and MD Anderson Dysphagia Inventory (MDADI), psychological distress using the Hospital Anxiety and Depression Scale (HADS), and xerostomia using the Xerostomia Inventory (XI). Associations were examined using Spearman correlations with Benjamini-Hochberg correction and exploratory rank-transformed multiple linear regression.Results
FEES parameters showed no significant bivariate associations with SSQ or MDADI total scores after correction. HADS and XI showed moderate to strong bivariate associations with SSQ and MDADI. In exploratory multivariable analyses, HADS (β = 0.372, p = 0.012) and PAS max (β = 0.318, p = 0.006) were independently associated with SSQ, whereas XI was not (β = 0.268, p = 0.065). HADS (β = -0.339, p = 0.008), XI (β = -0.433, p < 0.001), and PAS max (β = -0.301, p = 0.003) were independently associated with MDADI.Conclusion
The FEES-derived parameters only partially reflected patient-reported swallowing impairment. These findings support a multidimensional understanding of post-therapeutic dysphagia and suggest routine integration of psychosocial and symptom-oriented assessments into follow-up care in this specific patient population.Level of evidence
4.Trial registration
German Clinical Trials Register (DRKS) Registration Number: DRKS00038870.
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BibTeX
@article{seuthe2026patientreported,
title = {{Patient-Reported Dysphagia After Multimodal Therapy and Radial Forearm Free-Flap Reconstruction for OPSCC: Associations With FEES Findings, Psychological Distress, and Xerostomia.}},
author = {Inga Marte Charlott Seuthe and Julius Friedrich Ennenbach and Natalja Bolotina and Nermin Rüdiger and Sabine Eichhorn and Eren Erdogan and Stijn Bogaert and Stefan Dazert and Steffen Maune and Jonas Jae-Hyun Park},
journal = {Laryngoscope investigative otolaryngology},
year = {2026},
month = oct,
doi = {10.1002/lio2.70617},
url = {https://europepmc.org/article/MED/42908754},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient-Reported Dysphagia After Multimodal Therapy and Radial Forearm Free-Flap Reconstruction for OPSCC: Associations With FEES Findings, Psychological Distress, and Xerostomia.
AU - Inga Marte Charlott Seuthe
AU - Julius Friedrich Ennenbach
AU - Natalja Bolotina
AU - Nermin Rüdiger
AU - Sabine Eichhorn
AU - Eren Erdogan
AU - Stijn Bogaert
AU - Stefan Dazert
AU - Steffen Maune
AU - Jonas Jae-Hyun Park
PY - 2026
DA - 2026/10/20
JO - Laryngoscope investigative otolaryngology
DO - 10.1002/lio2.70617
UR - https://europepmc.org/article/MED/42908754
AB - Objective This study investigated whether fiberoptic endoscopic evaluation of swallowing (FEES)-derived parameters reflect patient-reported dysphagia and swallowing-related quality of life in patients with oropharyngeal squamous cell carcinoma (OPSCC) after surgery-based multimodal therapy with free-flap reconstruction. In addition, it assessed the roles of psychological distress and xerostomia in this context.Methods This multicenter, cross-sectional exploratory study included 50 patients. FEES parameters comprised Penetration-Aspiration Scale (PAS) and residue scores. Patient-reported outcomes were assessed using the Sydney Swallow Questionnaire (SSQ) and MD Anderson Dysphagia Inventory (MDADI), psychological distress using the Hospital Anxiety and Depression Scale (HADS), and xerostomia using the Xerostomia Inventory (XI). Associations were examined using Spearman correlations with Benjamini-Hochberg correction and exploratory rank-transformed multiple linear regression.Results FEES parameters showed no significant bivariate associations with SSQ or MDADI total scores after correction. HADS and XI showed moderate to strong bivariate associations with SSQ and MDADI. In exploratory multivariable analyses, HADS (β = 0.372, p = 0.012) and PAS max (β = 0.318, p = 0.006) were independently associated with SSQ, whereas XI was not (β = 0.268, p = 0.065). HADS (β = -0.339, p = 0.008), XI (β = -0.433, p < 0.001), and PAS max (β = -0.301, p = 0.003) were independently associated with MDADI.Conclusion The FEES-derived parameters only partially reflected patient-reported swallowing impairment. These findings support a multidimensional understanding of post-therapeutic dysphagia and suggest routine integration of psychosocial and symptom-oriented assessments into follow-up care in this specific patient population.Level of evidence 4.Trial registration German Clinical Trials Register (DRKS) Registration Number: DRKS00038870.
SN - 2378-8038
ER -