Physical Properties of Meals that are Suitable for Patients after Surgery to Treat Oral Cavity Cancers

OBJECTIVES: To determine proper characteristics of food which would be safe and satisfactory for swallowing in oral cavity cancer patients undergoing surgery and to create a recipe that provides adequate nutrients, energy, good taste, and can be easily made at home. MATERIALS AND METHODS: Patients who were enrolled in this study underwent oral cancer surgery in the Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital from September 2017 to July 2018. This experimental research was conducted postoperatively before receiving chemoradiation. Each type of food was prepared by the researchers to have a combination of two physical properties, which were 3 different consistencies (liquid, nectar-like, and honey-like) and 2 different temperatures (room temperature (25ºC) and cold temperature (4ºC)). Each patient had to swallow six different types of prepared food by random sequences. Flexible endoscopic evaluation of swallowing (FEES) was used to evaluate objective swallowing function by 3 parameters, including premature oropharyngeal spillage, laryngeal penetration or aspiration, and post-swallow retaining residues. Satisfaction measurement was evaluated with visual analog scale (VAS). RESULTS: There were 42 postoperative oral cavity cancer patients enrolled in this study. Subjects consisted of 23 males (54.8%) and 19 females (45.2%) with the mean age of 62 ± 13 years. Most patients had oral tongue carcinoma (64.3 %). FEES revealed nectar at room temperature was the safest with score of 0.83 ± 0.82 (possible score of 0-3, with 0 was best). However, patients significantly preferred liquid at room temperature more than other kinds of food (VAS taste = 8.26 ± 1.52 and VAS easy swallowing = 8.05 ± 1.74). When evaluating specifically in patients with oral tongue cancer, FEES scores, VAS taste, and VAS easy swallowing showed similar results the liquid at room temperature was the best. CONCLUSIONS: We suggested that the nectar-like thickened food at room temperature was determined to be the most proper food characteristic for oral cancer patients undergoing surgery in order to prevent aspiration. However, patients’ satisfaction analysis suggested that they preferred other type of food. The physician should advise patients of the proper kind of food for safe swallowing and avoidance of serious complication especially aspiration pneumonia.