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Summary: Background & aims: To determine the prevalence of dysphagia in head and neck cancer patients treated with surgery and radiotherapy or chemoradiotherapy. To study the impact of dysphagia on food habits, nutritional status, and quality of life. Methods: Retrospective cross-sectional study of 87 head and neck cancer patients treated with surgery and radiotherapy or chemoradiotherapy from January 2000 through May 2005. Time since surgery was 28.5±17.8 months. A clinical test was used to detect dysphagia. A nutritional assessment was performed in all patients. A questionnaire was used to evaluate quality of life. Results: Oropharyngeal dysphagia was present in 50.6% of patients, mostly to solid foods (72.4%). Patients with total glossectomy and chemoradiotherapy had the highest rate of dysphagia. Nutritional support was necessary in 57.1% of patients. Malnutrition was present in 20.3% of patients, mainly marasmus (81%). Fifty-one percent of patients reported a decrease in their quality of life due to dysphagia. Conclusions: We found a high prevalence of dysphagia in head and neck cancer patients treated with surgery and coadjuvant treatment. This problem negatively affects their quality of life. It is important that nutritional surveillance be provided to detect it and to prevent malnutrition. [Copyright &y& Elsevier]

Thickening products (TPs) are a valid therapeutic strategy in patients with oropharyngeal dysphagia, their effect is mainly related to the bolus viscosity achieved. The aim of the study was to compare the information on the labels of 10 TPs of different thickening agents (hydrocolloids): modified starch-based, gum-based and mixtures. Viscosity was measured in SI units (mPa·s), using a rotational viscometer at 50 s−1 and 300 s−1, and the effect of oral amylase (α-SA) and shear thinning on the viscosity levels recommended by each manufacturer were assessed. Results were classified according to 3 textural classifications: National Dysphagia Diet (NDD), International Dysphagia Diet System (IDDSI) and Japanese Dysphagia Diet (JDD2013). Results are also presented in SI units (mPa·s) following a new proposed scientific labelling system developed in our laboratory at Hospital de Mataró and endorsed by eleven medical and scientific societies. The effect of α-SA was assessed after 30 s oral incubation of the thickened bolus. All TPs fulfil Food for Special Medical Purposes labelling regulations, use 3 thickness levels, and 70% use the NDD descriptors. Viscosities at 50 s−1 ranged between 75 and 350 mPa s for level 1, 256–1280 for level 2 and 377–6205 for level 3. α-SA caused 98–99% decrease in viscosity for modified starch-based TPs (MS) and 16% or even an increment for gum-based TPs. Shear thinning decreased viscosity from 40 to 60% for MS-based TPs and 70–75% for gum-based TPs. This study showed that TPs are commercialised using the same descriptors for very different viscosities when measured in mPa·s. Shear rate and α-SA strongly affect viscosity but this is not described on the labels. We claim labels should include viscosity in SI Units (mPa·s at 50 s−1) and the effect of α-SA and shear thinning as main factors affecting the therapeutic effect and mode of action of thickening agents. [Display omitted] [ABSTRACT FROM AUTHOR]