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Prevalence of profound laryngeal sensory neuropathy in head and neck cancer survivors with feeding tube‐dependent oropharyngeal dysphagia
Author(s) -
Mehdizadeh Omid B.,
Dhar Shumon I.,
Evangelista Lisa,
NativZeltzer Nogah,
Bewley Arnaud F.,
Belafsky Peter C.
Publication year - 2020
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.26059
Subject(s) - medicine , swallowing , dysphagia , larynx , pharynx , palpation , head and neck cancer , pharyngeal muscles , esophagus , feeding tube , surgery , cancer
Abstract Background Laryngopharyngeal sensory neuropathy (LSN) has been observed to be a contributing factor to swallowing dysfunction in head and neck cancer (HNC) survivors. Methods Retrospective review of 43 tube‐dependent HNC survivors was conducted. LSN was assessed with direct palpation of the aryepiglottic fold and by traversing the true vocal folds without eliciting a cough reflex with a flexible laryngoscope. Results The primary tumor sites were oropharynx (51%), larynx (14%), nasopharynx (4.7%), oral cavity (14%), thyroid (4.7%), unknown primary (9.3%), and esophagus (2.3%). The prevalence of profound LSN was 79.1%. Objective fluoroscopic parameters contributing to swallowing dysfunction were diminished laryngohyoid elevation (100%), pharyngeal weakness (67%), and reduced lateral PES opening (37%). Conclusions The prevalence of LSN in HNC survivors with feeding tube‐dependent dysphagia is high (79.1%). The data suggest that LSN, in addition to fibrosis, pharyngoesophageal stenosis, and cranial nerve motor deficits contributes to swallowing dysfunction in these patients.