Oral Hygiene
Poor oral hygiene has also been separately demonstrated as an
independent risk factor for the development of HNSCC and has been
associated with poorer overall survival in several
series.76-80 In addition to the mechanism of
pathogenic oral cavity and oropharyngeal bacteria in the development of
carcinoma and pneumonia, improved oral hygiene may also reduce
mortality. Decrease in mortality may be associated with decreased
pneumonia incidence and severity as well as the oncologic benefits
conferred through routine dental and oral cavity
surveillance.81-83 This further underscores the
importance of maintaining a healthy oral cavity, particularly in older
patients and those with previously treated
HNSCC.65,66,84 In all, increased attention should be
paid to modifiable risk factors including smoking, oral hygiene, and
nutrition status in order to mitigate aspiration risks.
CONCLUSIONS :
Primary COVID-19 infections are more likely to cause pulmonary
complications (and mortality) in men, older patients, those with
underlying prior or current cancers, and patients with concomitant lung
conditions (such as COPD and prior smoking). Patients with head and neck
cancer share similar attributes with those at highest risk for adverse
outcomes with COVID-19 infection.3-6 Toxicities from
CRT have been demonstrated to significantly increase rates of aspiration
and pneumonia within this cohort.6-8 HNSCC patients
are at increased risk for a variety of viral and bacterial pulmonary
infections, which depend upon the underlying mechanism of
immunosuppression. Interventions designed to decrease smoking and
alcohol use, improve oral hygiene, maximize nutrition, and treat
underlying medical comorbidities are central to the short and long-term
management of patients with HNSCC, especially during the COVID-19 era.