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Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck
Author(s) -
Kotz Tamar,
Costello Rosemary,
Li Yi,
Posner Marshall Roy
Publication year - 2004
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.10385
Subject(s) - swallowing , medicine , head and neck , head and neck squamous cell carcinoma , basal cell , oncology , head and neck cancer , radiology , radiation therapy , surgery
Background. Swallowing dysfunction is a common side effect of chemoradiation. Methods. Twelve patients with stage III or IV squamous cell carcinoma of the head and neck were enrolled. Videofluorographic swallowing studies were performed before initiation of chemoradiation to provide baseline swallowing function data. Postchemoradiation videofluorographic swallowing studies were performed from 1 to 14 weeks after the completion of treatment (mean, 8 weeks). Results. Changes in swallowing physiology after treatment included decreased base of tongue to posterior pharyngeal wall contact ( p = .0010) and reduced pharyngeal contraction ( p = .0313), resulting in impaired bolus transport through the pharynx. In addition, decreased laryngeal elevation ( p = .0039), decreased laryngeal vestibule closure ( p = .0078), and laryngeal penetration ( p = .0078) were present. Bolus volume did not have a significant effect on swallowing ability. Aspiration was observed in four patients. Conclusions. Organ preservation treatment impairs movement of structures essential for normal swallowing. Prophylactic swallowing exercises may benefit these patients. © 2004 Wiley Periodicals, Inc. Head Neck 26: 365–372, 2004