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Late radiation‐associated dysphagia with lower cranial neuropathy in long‐term oropharyngeal cancer survivors: Video case reports
Author(s) -
Hutcheson Katherine A.,
Yuk Margaret M.,
Holsinger F. Christopher,
Gunn G. Brandon,
Lewin Jan S.
Publication year - 2015
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.23840
Subject(s) - medicine , dysphagia , swallowing , head and neck cancer , radiation therapy , hypopharyngeal cancer , cancer , oropharyngeal dysphagia , surgery
Background Lower cranial neuropathies are a late effect of radiotherapy (RT), typically reported in nasopharyngeal cancer survivors. Limited data examine these neuropathies after oropharyngeal cancer, particularly as it relates to late radiation‐associated dysphagia (late‐RAD). Methods Two cases were examined over 4 to 6 years. Late‐RAD was assessed per MBS impairment profile (MBSImP™©), Penetration‐Aspiration Scale (PAS), Performance Status Scale for Head and Neck cancer (PSS‐HN), and MD Anderson Dysphagia Inventory (MDADI). Neuropathies were examined via clinical examination and laryngeal videostroboscopy, and compared with trajectories of late‐RAD. Results Media‐enriched case reports describe the course of late‐RAD and neuropathies in 2 cases after definitive RT ± epidermal growth factor receptor‐inhibitor for oropharyngeal cancer. Late‐RAD was characterized by severe physiologic impairments per MBSImP™© and decreased swallowing‐related quality of life (QOL) per MDADI. Trajectories of late‐RAD paralleled the progression or stability of neuropathies. Conclusion Late‐RAD with lower cranial neuropathies resulted in profound and persistent functional impairment. Rarely reported, late radiation‐associated lower cranial neuropathies may be a major contributor to new‐onset or progressive dysphagia in long‐term oropharyngeal cancer survivors. © 2014 Wiley Periodicals, Inc. Head Neck 37 : E56–E62, 2015