Date of Award

2022

Document Type

Capstone

Degree Name

Doctor of Occupational Therapy

Department

Occupational Therapy

First Advisor

Katherine Jones, MA, OTR/L, CLT-LANA

Second Advisor

Bernard Muriithi, PhD, OTR/L

Abstract

The American Cancer Society (2022) estimates about 54,000 new cases of oropharyngeal cancer in 2022. Oropharyngeal cancer, a type of head and neck cancer (HNC), typically refers to cancer in the base of tongue, oropharynx, tonsils, or mouth. The American Cancer Society (as cited by Cohen et al., 2016) recommends that physicians assess HNC survivors for lymphedema and refer them to a lymphedema therapist if necessary. Lymphedema presents as soft-tissue swelling and localized accumulation of high-protein fluid that can cause an inflammatory response resulting in disfigurement, tissue fibrosis, functional limitation, pain, and infections (Gutiérrez et al., 2020). There are two types of head and neck lymphedema: external and internal. External lymphedema involves external structures, such as the skin and soft tissues of the face and neck. Internal lymphedema involves internal structures, such as the mucosa and underlying soft tissue of the upper aerodigestive tract, including the pharynx and larynx (Deng et al., 2012). Lymphedema is caused by the obstruction of lymphatic vessels from tumors, scars, or radiation, or caused by the removal of lymphatic structures from dissection (Jeans, Ward, et al., 2021). The purpose of this study was to research the relationship between secondary head and neck lymphedema and dysphagia for individuals with oropharyngeal cancer post radiation treatment. The objective was to determine if lymphedema therapy and speech therapy have an effect on dysphagia, diet level, lymphedema severity, percutaneous endoscopic gastrostomy (PEG) tube placement, and hospital admission.

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