title: Swallowing after major surgery of the oral cavity or oropharynx: a prospective and longitudinal assessment of patients treated by microvascular soft tissue reconstruction.
abstract: BACKGROUND
  The aim of this study was to analyze swallowing outcome in advanced oral/oropharyngeal cancer patients treated with microvascular reconstructive surgery and adjuvant radiotherapy.
  
  
  METHODS
  Eighty patients were included. Patient, tumor, and treatment factors were assessed. Postoperative videofluoroscopic swallowing studies (VFSS) and scintigraphy tests were performed at 6 (n = 54 vs 44) and 12 (n = 32 vs 37) months. Swallowing parameters such as the oropharyngeal swallow efficiency and the Penetration/Aspiration Scale were analyzed.
  
  
  RESULTS
  Impaired swallowing status was found at 6 months, which remained stationary at 12 months. Comorbid condition, larger tumors (T3-T4 vs T2), and resections of the base of tongue and soft palate combined (vs defects of other dynamic structures) were associated with most profound swallowing problems (p < .05).
  
  
  CONCLUSIONS
  Swallowing difficulties are relatively frequent and can to a large extent be predicted. With the knowledge of this study, better counseling and vigilance as to swallowing difficulties may be possible.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: Pepijn A
authors.initials: PA
authors.lastname: Borggreven
authors.forename: Irma
authors.initials: I
authors.lastname: Verdonck-de Leeuw
authors.forename: Rico N
authors.initials: RN
authors.lastname: Rinkel
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.forename: Jan C
authors.initials: JC
authors.lastname: Roos
authors.forename: Eric F L
authors.initials: EF
authors.lastname: David
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D015897:Comorbidity; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D014059:Tongue / Q000601:surgery; D014741:Video Recording