European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 8, pp 2299–2304 | Cite as

Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy

  • Takashi Maruo
  • Yasushi Fujimoto
  • Kikuko Ozawa
  • Mariko Hiramatsu
  • Atsushi Suzuki
  • Naoki Nishio
  • Tsutomu Nakashima
Head and Neck


The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained.


Dysphagia Radiotherapy Laryngeal sensory Initiation of swallowing reflex Pharyngeal delay time 


Conflict of interest

We do not have a financial relationship with the organization that sponsored the research.


  1. 1.
    Eisele DW, Koch DG, Tarazi AE, Jones B (1991) Case report: aspiration from delayed radiation fibrosis of the neck. Dysphagia 6(2):120–122PubMedCrossRefGoogle Scholar
  2. 2.
    Hamlet S, Faull J, Klein B, Aref A, Fontanesi J, Stachler R, Shamsa F, Jones L, Simpson M (1997) Mastication and swallowing in patients with postirradiation xerostomia. Int J Rad Oncol Biol Phys 37(4):789–796CrossRefGoogle Scholar
  3. 3.
    Ozawa K, Fujimoto Y, Nakashima T (2010) Changes in laryngeal sensation evaluated with a new method before and after radiotherapy. Eur Arch Otorhinolaryngol 267(5):811–816PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Parise Junior O, Miguel RE, Gomes DL, Menon AD, Hashiba K (2004) Laryngeal sensitivity evaluation and dysphagia: hospital Sírio-Libanês experience. Sao Paulo Med J 122(5):200–203PubMedCrossRefGoogle Scholar
  5. 5.
    Ishibashi A, Fujishima I, Takahashi H, Katagiri N, Ohno R et al (2007) A new method of laryngeal sensory testing using endoscopy and fine probes for patients with dysphasia. Jibi 53:S153–S161Google Scholar
  6. 6.
    Yaguchi H, Fujishima I, Ohno T (2006) A new method of testing laryngopharyngeal sensory discrimination using a flexible laryngoscope and probes. Jibi 52:S256–S262Google Scholar
  7. 7.
    Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL (1996) A penetration–aspiration scale. Dysphagia 11(2):93–98PubMedCrossRefGoogle Scholar
  8. 8.
    Dietz A, Rudat V, Dreyhaupt J, Pritsch M, Hoppe F, Hagen R, Pfreundner L, Schröder U, Eckel H, Hess M, Schröder M, Schneider P, Jens B, Zenner HP, Werner JA, Engenhardt-Cabillic R, Vanselow B, Plinkert P, Niewald M, Kuhnt T, Budach W, Flentje M (2009) Induction chemotherapy with paclitaxel and cisplatin followed by radiotherapy for larynx organ preservation in advanced laryngeal and hypopharyngeal cancer offers moderate late toxicity outcome (DeLOS-I-trial). Eur Arch Otorhinolaryngol 266(8):1291–1300PubMedCrossRefGoogle Scholar
  9. 9.
    Rudat V, Eckel H, Volling P, Schröder M, Staar S, Wallner F, Wannenmacher M, Dietz A (2008) Long-term results of a prospective multicenter phase II study to preserve the larynx function using concomitant boost radiochemotherapy with carboplatin. Radiother Oncol 89(1):33–37PubMedCrossRefGoogle Scholar
  10. 10.
    Jensen K, Lambertsen K, Grau C (2007) Late swallowing dysfunction and dysphagia after radiotherapy for pharynx cancer: frequency, intensity and correlation with dose and volume parameters. Radiother Oncol 85(1):74–82PubMedCrossRefGoogle Scholar
  11. 11.
    van der Molen L, van Rossum MA, Burkhead LM, Smeele LE, Hilgers FJ (2009) Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review. Eur Arch Otorhinolaryngol 266(6):889–900PubMedCrossRefGoogle Scholar
  12. 12.
    Smith RV, Kotz T, Beitler JJ, Wadler S (2000) Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea: initial results. Arch Otolaryngol Head Neck Surg 126(3):384–389PubMedCrossRefGoogle Scholar
  13. 13.
    Miller AJ (1982) Deglutition. Physiol Rev 62(1):129–184PubMedGoogle Scholar
  14. 14.
    Ali GN, Laundl TM, Wallace KL, deCarle DJ, Cook IJ (1996) Influence of cold stimulation on the normal pharyngeal swallow response. Dysphagia 11(1):2–8PubMedCrossRefGoogle Scholar
  15. 15.
    Jean A (2001) Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev 81(2):929–969PubMedGoogle Scholar
  16. 16.
    Miller AJ (1972) Characteristics of the swallowing reflex induced by peripheral nerve and brain stem stimulation. Exp Neurol 34(2):210–222PubMedCrossRefGoogle Scholar
  17. 17.
    Sinclair WJ (1971) Role of the pharyngeal plexus in initiation of swallowing. Am J Physiol 221(5):1260–1263PubMedGoogle Scholar
  18. 18.
    Shingai T, Shimada K (1976) Reflex swallowing elicited by water and chemical substances applied in the oral cavity, pharynx, and larynx of the rabbit. Jpn J Physiol 26(5):455–469PubMedCrossRefGoogle Scholar
  19. 19.
    Storey AT (1968) A functional analysis of sensory units innervating epiglottis and larynx. Exp Neurol 20(3):366–383PubMedCrossRefGoogle Scholar
  20. 20.
    Kitagawa J, Nakagawa K, Hasegawa M, Iwakami T, Shingai T, Yamada Y, Iwata K (2009) Facilitation of reflex swallowing from the pharynx and larynx. J Oral Sci 51(2):167–171PubMedCrossRefGoogle Scholar
  21. 21.
    Kim Y, McCullough GH, Asp CW (2005) Temporal measurements of pharyngeal swallowing in normal populations. Dysphagia 20:290–296PubMedCrossRefGoogle Scholar
  22. 22.
    Wang TG, Chang YC, Chen WS, Lin PH, Hsiao TY (2010) Reduction in hyoid bone forward movement in irradiated nasopharyngeal carcinoma patients with dysphagia. Arch Phys Med Rehab 91(6):926–931CrossRefGoogle Scholar
  23. 23.
    Ishida R, Palmer JB, Hiiemae KM (2002) Hyoid motion during swallowing: factors affecting forward and upward displacement. Dysphagia 17(4):262–272PubMedCrossRefGoogle Scholar
  24. 24.
    Leonard RJ, Kendall KA, McKenzie S, Gonçalves MI, Walker A (2000) Structural displacements in normal swallowing: a video-fluoroscopic study. Dysphagia 15(3):146–152PubMedCrossRefGoogle Scholar
  25. 25.
    Ertekin C, Aydogdu I (2002) Electromyography of human cricopharyngeal muscle of the upper esophageal sphincter. Muscle Nerve 26(6):729–739PubMedCrossRefGoogle Scholar
  26. 26.
    Kapur TR (1968) Late post radiation changes in the larynx, pharynx, oesophagus and the trachea. J Laryngol Otol 82(5):447–457PubMedCrossRefGoogle Scholar
  27. 27.
    Chi-Fishman G, Sonies BC (2002) Kinematic strategies for hyoid movement in rapid sequential swallowing. J Speech Lang Hear Res 45(3):457–468PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Takashi Maruo
    • 1
  • Yasushi Fujimoto
    • 1
  • Kikuko Ozawa
    • 1
  • Mariko Hiramatsu
    • 1
  • Atsushi Suzuki
    • 1
  • Naoki Nishio
    • 1
  • Tsutomu Nakashima
    • 1
  1. 1.Department of OtorhinolaryngologyNagoya University Graduate School of MedicineNagoyaJapan

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