Dysphagia After Lip and Oral Cavity Surgery

  • Samskruthy P. Murthy
  • Krishnakumar Thankappan
  • Jayakumar R. Menon


Swallowing is a complex neuromuscular process, which involves sphincteric action at various levels in the upper aerodigestive system. Swallowing has been classically divided into oral phase, pharyngeal phase, and esophageal phase. The oral phase is voluntary, while the rest of the phases are involuntary. Oral phase is also divided into a preparatory, masticatory phase where food is prepared into a bolus and oral phase proper in which the bolus is propelled into the pharynx by squeezing action of the tongue against the palate. Mastication is a complex process that requires well-coordinated movements of temporomandibular joint, muscles of mastication, and tongue musculature. Adequate salivation plays an integral part in mastication by softening solid food particles and coats bolus for easy passage through the upper digestive tract. Surgeries of oral cavity significantly affect oral preparatory phase and the oral phase. Dysphagia is extremely debilitating and the main factor affecting the quality of life in postsurgical oral cancer patients. As a consequence of surgical resection, the anatomical tissue volume loss results in impairment of mastication. The problems vary depending on the structure excised, the extent of tissue loss, and the mode of reconstruction.

Supplementary material

Video 20.1

Anterior bolus spill in a patient with buccal and commissure resection (Case 2) (MP4 26711 kb)

Video 20.2

Patient uses manual lip support, head back position as compensatory techniques (Case 2) (MP4 44313 kb)

Video 20.3

Patient with T3 tongue carcinoma (Case 3) postsurgery uses head back compensatory maneuver for swallowing in the early postoperative period (MP4 57897 kb)

Video 20.4

FEES, Case 4 (MP4 178978 kb)

Video 20.5

VFS, Case 4 (MP4 126837 kb)

Video 20.6

VFS, Case 5 (MP4 129859 kb)

Video 20.7

Oral Scopy, Case 6 (MP4 76092 kb)

Video 20.8

FEES, Case 6 (MP4 135735 kb)

Video 20.9

VFS, Case 6 (MP4 93720 kb)

Video 20.10

VFS, Case 7 (MP4 55488 kb)

Video 20.11

Oral Scopy, Case 8 (MP4 71388 kb)

Video 20.12

FEES, Case 8 (MP4 126895 kb)

Video 20.13

VFS, Case 8 (MP4 74528 kb)


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Samskruthy P. Murthy
    • 1
  • Krishnakumar Thankappan
    • 1
  • Jayakumar R. Menon
    • 2
    • 3
  1. 1.Department of Head and Neck Surgery and OncologyAmrita Institute of Medical Sciences, Amrita Vishwa VidyapeethamKochiIndia
  2. 2.Department of LaryngologyKerala Institute of Medical SciencesThiruvananthapuramIndia
  3. 3.Dysphagia Unit, Department of Head and Neck SurgeryAmrita Institute of Medical Sciences, Amrita Vishwa VidyapeethamKochiIndia

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