Swallowing dysfunction after chemoradiation for advanced squamous cell carcinoma of the head and neck.
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.
Kotz
Tamar
T
Brigham and Women's Hospital, Boston, Massachusetts, USA.
Costello
Rosemary
R
Li
Yi
Y
Posner
Marshall Roy
MR
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D001239:Inhalation / Q000502:physiology; D007830:Larynx / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology; D011878:Radiotherapy / Q000009:adverse effects; D012494:Sampling Studies; D014741:Video Recording