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Effectiveness of the Cough Reflex in Patients with Aspiration Following Radiation for Head and Neck Cancer

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Abstract

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.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Arizona, 1501 N Campbell Avenue, P.O. Box 245081, Tucson, Arizona, 85724, USA

    Nam P. Nguyen

  2. Audiology and Speech Pathology, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, Texas, 75216, USA

    Candace C. Moltz, Cheryl Frank & Carrie Millar

  3. Department of Radiology, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, Texas, 75216, USA

    Herbert J. Smith

  4. Department of Radiation Oncology, University of Southern California, Los Angeles, California, 90033, USA

    Suresh Dutta

  5. University of Texas Southwestern Medical Center at Dallas, Harry Hines Boulevard, Dallas, Texas, 75390, USA

    Phuc D. Nguyen

  6. University of Michigan School of Public Health, 109 Observatory Street, Ann Arbor, Michigan, 48109, USA

    Ly M. Nguyen

  7. Department of Radiation Oncology, Val D’Aurelle, Montpellier, France

    Claire Lemanski

  8. Department of Radiation Oncology, Cleveland VA Medical Center, 10701 East Boulevard, Ohio, Cleveland, 44106, USA

    Adir Ludin

  9. Department of Radiation Oncology, Overton Brooks VA Medical Center, 510 E. Stoner Avenue, Shreveport, Louisiana, 71101, USA

    Beng-Hoey Jo

  10. Hematology Research Division, Novo Nordisk, Athens, Greece

    Sabah Sallah

Authors
  1. Nam P. Nguyen
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  2. Candace C. Moltz
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  3. Cheryl Frank
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  4. Carrie Millar
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  5. Herbert J. Smith
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  6. Suresh Dutta
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  7. Phuc D. Nguyen
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  8. Ly M. Nguyen
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  9. Claire Lemanski
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  10. Adir Ludin
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  11. Beng-Hoey Jo
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  12. Sabah Sallah
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Corresponding author

Correspondence to Nam P. Nguyen.

Additional information

The authors would like to thank Randy Stewart and Roberta Weiss for the assistance in the preparation of this manuscript.

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Nguyen, N.P., Moltz, C.C., Frank, C. et al. Effectiveness of the Cough Reflex in Patients with Aspiration Following Radiation for Head and Neck Cancer. Lung 185, 243–248 (2007). https://doi.org/10.1007/s00408-007-9016-z

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  • DOI: https://doi.org/10.1007/s00408-007-9016-z

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