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Therapeutic Singing as a Swallowing Intervention in Head and Neck Cancer Patients With Dysphagia

 Seongmoon Jo  ;  Myung Sun Yeo  ;  Yoon-Kyum Shin  ;  Ki Hun Shin  ;  Se-Heon Kim  ;  Hye Ryun Kim  ;  Soo Ji Kim  ;  Sung-Rae Cho 
 INTEGRATIVE CANCER THERAPIES, Vol.20 : 15347354211065040, 2021-12 
Journal Title
Issue Date
aspiration ; deglutition disorders ; head and neck cancer ; laryngeal elevation ; singing
Background: Head and neck cancer patients often suffer from dysphagia after surgery and radiotherapy. A singing-enhanced swallowing protocol was established to improve their swallowing function. This study aimed to evaluate the beneficial effects of therapeutic singing on dysphagia in head and neck cancer (HNC) patients.

Methods: Patients who participated in this study were allocated to the intervention group (15 patients) and the control group (13 patients). Patients assigned to the intervention group received therapeutic singing 3 times per week for 4 weeks. Each group was divided into 2 subgroups, including the oral cavity cancer group and the pharyngeal cancer group. The patients' vocal functions were evaluated in maximum phonation time, pitch, intensity, jitter, shimmer, harmonics to noise ratio, and laryngeal diadochokinesis (L-DDK). To evaluate swallowing function, videofluoroscopic swallowing study was done, and the results were analyzed by videofluoroscopic dysphagia scale (VDS) and dynamic imaging grade of swallowing toxicity (DIGEST).

Results: Among the voice parameters, L-DDK of the intervention group significantly increased compared to that of the control group. Swallowing functions of the intervention group were significantly improved in VDS and DIGEST after the intervention. Detailed items of VDS and DIGEST showed improvements especially in the pharyngeal phase score of VDS, such as laryngeal elevation, pharyngeal transit time, and aspiration. In addition, the pharyngeal cancer group showed significant improvements in VDS and DIGEST scores after the intervention.

Conclusions: Our outcomes highlight the beneficial effects of singing for HNC patients with dysphagia. The notable improvements in the pharyngeal phase suggest that therapeutic singing would be more appropriate for HNC patients who need to improve their intrinsic muscle movements of vocal fold and laryngeal elevation.
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1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Heon(김세헌)
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Shin, Yoon Kyum(신윤겸) ORCID logo https://orcid.org/0000-0001-5461-660X
Cho, Sung-Rae(조성래) ORCID logo https://orcid.org/0000-0003-1429-2684
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