pp 1–11 | Cite as

Predicting Swallowing Outcomes from Objective Videofluoroscopic Timing and Displacement Measures in Head and Neck Cancer Patients

  • Mathew B. Vansant
  • Lindsey A. Parker
  • Andrew J. McWhorter
  • David Bluoin
  • Melda KundukEmail author
Original Article


Radiation therapy with or without chemotherapy compromises swallowing efficiency and safety in patients with head and neck cancer (HNC). The resulting dysphagia leads to overall morbidity, with altered diets, reduced nutritional intake, reduced quality of life, and potential interruption of curative cancer treatment. Despite well-documented radiation-related changes in swallowing physiology, scarce research exists on the potential clinical value for measurements of swallowing timing and displacement in this population. This study investigated the discriminatory value of quantitative timing and displacement parameters for the Functional Oral Intake Scale and Penetration Aspiration Scale scores using pre- and post-radiation videofluoroscopy data. Swallowtail Software Version 1 (Belldev Medical, Arlington Heights, IL) was used to obtain objective timing and displacement measurements from the pre- and post-radiation videofluoroscopy data for 31 patients who underwent radiation therapy, with or without chemotherapy, for head and neck cancer. The total pharyngeal transit time (BP2) (p < 0.000, r = 0.43) in pudding bolus trials and the maximal upper esophageal sphincter opening (PESMax/cm) (p = 0.001, r = 0.31) in thin bolus trials were discriminatory for Functional Oral Intake Scale (FOIS). Findings suggest that measurement of post-radiation changes using objective and quantitative parameters may offer some discriminatory value regarding future dysphagia risk and prognosis based on total pharyngeal transit time and degree of UES opening. In addition, the results suggest that different bolus types may offer different discriminatory values in HNC population, and that some timing and displacement variables may have discriminatory value for patients’ diet levels independent from any aspiration risk.


Dysphagia Deglutition Deglutition disorders Radiation Timing Displacement Cancer 


Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Mathew B. Vansant
    • 1
    • 3
    • 5
  • Lindsey A. Parker
    • 1
    • 3
  • Andrew J. McWhorter
    • 1
    • 3
    • 4
  • David Bluoin
    • 2
  • Melda Kunduk
    • 1
    • 3
    • 4
    Email author
  1. 1.Department of Communication Science and DisordersLouisiana State UniversityBaton RougeUSA
  2. 2.Department of Experimental StaticsLouisiana State UniversityBaton RougeUSA
  3. 3.Our Lady of the Lake Regional Medical Center -Voice CenterBaton RougeUSA
  4. 4.Department of Otolaryngology-Head and Neck SurgeryLouisiana State University Health Sciences CenterNew OrleansUSA
  5. 5.Department of Communication Science and DisordersUniversity of MontevalloMontevalloUSA

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