Effectiveness of the cough reflex in patients with aspiration following radiation for head and neck cancer.
The effectiveness of the cough reflex in patients who aspirated following radiation for head and neck cancer was evaluated in 89 patients (49 chemoradiation, 33 postoperative radiation, and 7 radiation alone). All patients had modified barium swallow because of dysphagia. The cough reflex was graded as present and effective, ineffective, intermittently effective, or absent. All patients were cancer-free at the time of the swallowing study. The cough reflex was present and effective in 46 patients (52%), ineffective in 17 patients (19%), and absent in 26 patients (29%) on initial investigation. Among the 43 patients who had ineffective or absent cough reflex, their treatment was chemoradiation (26), postoperative radiation (13), and radiation alone (4). In 30 patients who had sequential modified barium swallow, the cough reflex was constantly effective, ineffective, or intermittently effective in 12 (40%), 13 (43%), and 5 (17%) patients, respectively. The cough reflex was frequently ineffective or absent in patients who aspirated following radiation for head and neck cancer. Cough may also be intermittently ineffective to protect the airways following radiation.
Nguyen
Nam P
NP
Department of Radiation Oncology, University of Arizona, 1501 N Campbell Avenue, P.O. Box 245081, Tucson, Arizona, 85724, USA. NamPhong.Nguyen@yahoo.com.
Moltz
Candace C
CC
Audiology and Speech Pathology, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, Texas, 75216, USA.
Frank
Cheryl
C
Audiology and Speech Pathology, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, Texas, 75216, USA.
Millar
Carrie
C
Audiology and Speech Pathology, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, Texas, 75216, USA.
Smith
Herbert J
HJ
Department of Radiology, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, Texas, 75216, USA.
Dutta
Suresh
S
Department of Radiation Oncology, University of Southern California, Los Angeles, California, 90033, USA.
Nguyen
Phuc D
PD
University of Texas Southwestern Medical Center at Dallas, Harry Hines Boulevard, Dallas, Texas, 75390, USA.
Nguyen
Ly M
LM
University of Michigan School of Public Health, 109 Observatory Street, Ann Arbor, Michigan, 48109, USA.
Lemanski
Claire
C
Department of Radiation Oncology, Val D'Aurelle, Montpellier, France.
Ludin
Adir
A
Department of Radiation Oncology, Cleveland VA Medical Center, 10701 East Boulevard, Ohio, Cleveland, 44106, USA.
Jo
Beng-Hoey
BH
Department of Radiation Oncology, Overton Brooks VA Medical Center, 510 E. Stoner Avenue, Shreveport, Louisiana, 71101, USA.
Sallah
Sabah
S
Hematology Research Division, Novo Nordisk, Athens, Greece.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003371:Cough / Q000503:physiopathology*; D016371:Cranial Irradiation / Q000009:adverse effects*; D003680:Deglutition Disorders / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012018:Reflex; D053120:Respiratory Aspiration / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies