Oropharyngeal dysphagia in head and neck cancer: how to reduce aspiration pneumonia.

OBJECTIVE: Oropharyngeal dysphagia is caused by difficulty in bolus preparation and transport from the mouth to the oesophagus; this may result in malnutrition and aspiration pneumonia. It has a high prevalence in head and neck cancer patients. The objective of this study is to reduce these complications using a new protocol of diagnosis and evaluation of oropharyngeal dysphagia. METHOD: This is a prospective study developed in a secondary hospital. All patients diagnosed with head and neck cancer in 2021 and 2022 are subjected to this protocol: an oropharyngeal dysphagia screening test, a swallowing-related quality of life questionnaire and a flexible endoscopic evaluation of swallow. RESULTS: A total of 72 evaluations are reported using this protocol, before and after cancer treatment, and only 1 presents with aspiration pneumonia. CONCLUSION: Using this protocol, the incidence of aspiration pneumonia can be reduced, and diet recommendations can be given earlier in order to maintain a patient's nutritional requirements.

[Rhinoscleroma. A case report]. / Rinoescleroma. A propósito de un caso.

Rhinoscleroma is a chronic, specific, inflammatory granulomatous condition of the nose and other structures of the upper respiratory tract. It is caused by the bacterium Klebsiella rhinoscleromatis. We report a case in a 29-year-old black male emigrant who consulted for a 2-year history of hoarseness, cough, and nasal discharge. The diagnosis was scleroma with nasal, laryngeal, tracheal, and bronchial involvement and ulcerating and necrotizing lesions that caused respiratory obstruction. Bacterial over-infection responded to treatment with third-generation cephalosporins and clindamycin. The sclerotic lesions responded well to treatment with ciprofloxacin. We review the clinical findings at different stages, diagnostic options, and several treatments.