American Speech-Language-Hearing Association

EBP Compendium: Summary of Clinical Practice Guideline

Ontario Ministry of Health and Long-Term Care (Canada)
The Management of Head and Neck Cancer in Ontario: Organizational and Clinical Practice Guideline Recommendations

Gilbert, R., Devries-Aboud, M., et al. (2009).
Cancer Care Ontario, 63 pages.

AGREE Rating: Highly Recommended

Description:

This guideline provides recommendations for the assessment, treatment and management of individuals with head and neck cancer. The target audience of this guideline includes primary and extended care providers of patients with head and neck cancer. Speech-language pathologists were included in the core team of individuals involved in the coordinated care of this population. Recommendations were based on the work of the Head and Neck Management Working Group (HNMWG) as well as existing guidelines from the National Institute of Health and Clinical Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN).

Recommendations:

  • Assessment/Diagnosis
    • Assessment Areas
      • Speech/Voice
        • Head and neck cancer "patients undergoing chemoradiation should have access to an SLP before, during and after treatment" (SIGN) (p. 17).
        • Speech-language pathologists should evaluate patients soon after diagnosis for communication problems (SIGN).
        • Patients undergoing laryngectomy should be evaluated by a speech-language pathologists "to restore voice either by a tracheoesophageal voice prosthesis, esophageal speech, or electrolarynx" (SIGN) (p. 17).
    • Assessment Instruments
      • FEES/Videofluoroscopy
        • All patients with head and neck cancer should have access to instrumental swallowing assessment. The speech-language pathologist should determine the most appropriate form of assessment based on the patients needs and setting. (SIGN, HNMWG)
        • "Modified barium swallow and fiberoptic endoscopic evaluation of swallow are both valid methods of assessing dysphagia" (p. 17). The speech-language pathologist should determine the most appropriate form of assessment based on the patients needs and setting (HNMWG).
  • Treatment
    • Speech/Voice
      • Electrolarynx, Esophageal Speech, & Tracheoesophageal Voice Prothesis - Patients undergoing laryngectomy should be evaluated by a speech-language pathologist "to restore voice either by a tracheoesophageal voice prosthesis, esophageal speech, or electrolarynx" (SIGN) (p. 17).
    • Swallowing
      • General Findings - "Head and neck cancer patients with dysphagia should receive appropriate speech and language therapy to optimize residual swallow function and reduce aspiration risk" (SIGN) (p. 17). 

Keywords: Head and Neck Cancer

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Added to Compendium: November 2011

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