Long-term aspiration following treatment for head and neck cancer.
BACKGROUND
Dysphagia and aspiration are long-term complications with life-threatening consequences following treatment of head and neck cancer. We would like to assess the prevalence of aspiration in patients with long-term persistence of dysphagia (1 year or more) following treatment for head and neck cancer and to identify potential risk factors of aspiration.


METHODS
Modified barium swallow (MBS) examinations were performed in cancer-free patients who complained of dysphagia following treatment for head and neck cancer. The severity of the dysphagia was graded on a scale of 1-7.


RESULTS
Between 1992 and 2004, 74 patients with dysphagia underwent MBS 12-152 months following treatment (median 29 months). There were 2 grade 1, 22 grade 3, 21 grade 4, 11 grade 5, 7 grade 6, and 11 grade 7 cases. Twenty-nine patients (39%) had long-term aspiration at a median follow-up of 25 months (range 12-82). Eighteen patients (24%) required permanent gastrostomy because of severe aspiration. Type of treatment and disease stage did not seem to influence long-term aspiration risk.


CONCLUSIONS
Patients with long-term dysphagia after treatment for head and neck cancer are at risk of aspiration. MBS should be performed to identify these patients.
Nguyen
Nam P
NP
Department of Radiation Oncology, University of Arizona, Tucson, Arizona 85724-5081, USA. NamPhong.Nguyen@yahoo.com
Moltz
Candace C
CC
Frank
Cheryl
C
Vos
Paul
P
Smith
Herbert J
HJ
Karlsson
Ulf
U
Nguyen
Ly M
LM
Rose
Sue
S
Dutta
Suresh
S
Nguyen
Nga
N
Sallah
Sabah
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000145:classification / Q000150:complications / Q000209:etiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011832:Radiation Injuries; D012189:Retrospective Studies; D012307:Risk Factors