Contemporary successful management of patients with head and neck cancer often results in functional disability of communicative skills and nutritional maintenance. This proposal intends to study the effects of single and multimodality cancer therapy upon several important functions - specifically, self-care behavior and compliance, hearing, balance, speech, deglutition, taste, smell, mastication, and nutrition. The research program is divided into seven component projects. Project I evaluates the usefulness of educational interventions upon patient health, self-care behavior and compliance with prescribed regiments. Contracting methods will also be examined. Project II studies behavioral and objective measures of auditory and vestibular dysfunction and quantitates ototoxicity as a result of treatment protocols. Project III examines psychoacoustic and physical perspectives of speech production. Traditional physiologic, acoustic, and perceptual methods will be augmented by computer-based palatometry techniques. Early and late rehabilitative efforts will also be examined. Project IV evaluates swallowing dysfunction. Methods include videofluoroscopy and scintigraphy. Project V, on taste and olfaction, examines functional capacity before and after cancer treatment with tests for threshold identification. Project VI concentrates on mastication and analyzes masticatory performance and efficiency and swallowing indices with and without prosthetic devices. Nutritional interventions in Project VII studies alterations in nutritional status and efficacy of nutritional risk factors in this population. The design of the program provides ample opportunity for determining the effects of cancer therapy upon specific disabilities. Cross-study correlations should add information regarding the effects of one or several variables upon each other. The outcomes should be new data bases that can be used effectively in the planning of cancer treatment and the rehabilitation of the patient.
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