title: Late radiation-associated dysphagia with lower cranial neuropathy in long-term oropharyngeal cancer survivors: video case reports.
abstract: BACKGROUND
  Lower cranial neuropathies are a late effect of radiotherapy (RT), typically reported in nasopharyngeal cancer survivors. Limited data examine these neuropathies after oropharyngeal cancer, particularly as it relates to late radiation-associated dysphagia (late-RAD).
  
  
  METHODS
  Two cases were examined over 4 to 6 years. Late-RAD was assessed per MBS impairment profile (MBSImP™©), Penetration-Aspiration Scale (PAS), Performance Status Scale for Head and Neck cancer (PSS-HN), and MD Anderson Dysphagia Inventory (MDADI). Neuropathies were examined via clinical examination and laryngeal videostroboscopy, and compared with trajectories of late-RAD.
  
  
  RESULTS
  Media-enriched case reports describe the course of late-RAD and neuropathies in 2 cases after definitive RT ± epidermal growth factor receptor-inhibitor for oropharyngeal cancer. Late-RAD was characterized by severe physiologic impairments per MBSImP™© and decreased swallowing-related quality of life (QOL) per MDADI. Trajectories of late-RAD paralleled the progression or stability of neuropathies.
  
  
  CONCLUSIONS
  Late-RAD with lower cranial neuropathies resulted in profound and persistent functional impairment. Rarely reported, late radiation-associated lower cranial neuropathies may be a major contributor to new-onset or progressive dysphagia in long-term oropharyngeal cancer survivors.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Hutcheson
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Yuk
authors.forename: F Christopher
authors.initials: FC
authors.lastname: Holsinger
authors.forename: G Brandon
authors.initials: GB
authors.lastname: Gunn
authors.forename: Jan S
authors.initials: JS
authors.lastname: Lewin
mesh_terms: D000328:Adult; D003389:Cranial Nerve Diseases / Q000150:complications*; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies
keywords: cranial neuropathy; late dysphagia; late effects; oropharyngeal cancer; radiotherapy