Early rehabilitation of patients after radical surgical or combined treatment of oropharyngeal tumors: an interdisciplinary approach

This paper researches and substantiates the significant role of early rehabilitation of impaired or lost breathing, swallowing, and speech functions after radical surgical or combined treatment of oropharyngeal tumors. The purpose of the study is the optimization and increasing the effectiveness of comprehensive rehabilitation aimed at breathing and speech function recovery, as well as eating act recovery, in patients after surgical treatment of oropharyngeal tumors. Material and methods. The prospective study was conducted in several stages. A multidisciplinary team of specialists observed 82 patients (56 men and 26 women, aged 31 to 89 years) after surgical treatment of oropharyngeal tumors. The prehabilitation stage included joint consultations with the oncologist and speech pathologist; comprehensive preparation of patient for surgery; preliminary speech therapy, aimed at developing the functional basis for breathing, voice, and pronunciation. In early postoperative period a comprehensive speech assessment and Screening I (evaluation of swallowing function, speech intelligibility, and the rehabilitation potential level) were conducted. Based on the data obtained, a personalized rehabilitation program was developed for each patient. Early speech therapy with psychological support was initiated with the permission of the oncologist in a gentle way, then continued during the inpatient period and then during an outpatient period. Upon completion the psychological-pedagogical rehabilitation course, Screening II was conducted (re-evaluation of swallowing function, speech intelligibility, and the rehabilitation potential level). Discussion. Comprehensive rehabilitation program realization for patients with acquired defects and deformities of the oropharyngeal zone resulted in a positive effect across all aspects of the examination. Early starting of breathing and swallowing functions recovery, as well as speech function recovery, helped to prevent the development of pathological compensatory mechanisms and to increase the effectiveness of the rehabilitation process. A comparison of Screening I and Screening II data using the Mann-Whitney U-test revealed a significant reduction in dysphagia and speech disorders and a significant increase in rehabilitation potential. Conclusion. Following the early rehabilitation principle, as well as using of an interdisciplinary approach to rehabilitation, contributes to the highly effective recovery of impaired or lost breathing, swallowing, and speech functions after surgical treatment of oropharyngeal tumors.
Keywords: early rehabilitation, prehabilitation, dysphagia, acquired speech disorders, oropharyngeal tumors, principle of ablasticity, rehabilitation potential
Conflict of interest. The authors have no conflicts of interest.
Funding. The work was performed without external funding.