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Dysphagia pp 459-475 | Cite as

Dysphagia Evaluation and Treatment After Head and Neck Surgery and/or Chemo-radiotherapy for Head and Neck Malignancies

  • Antonio Schindler
  • Francesco Mozzanica
  • Filippo Barbiera
Part of the Medical Radiology book series (MEDRAD)

Abstract

Tumors of the head and neck represent 3.2 % of newly diagnosed cancers; both surgery and chemo-radiotherapy are valid treatment options for head and neck cancer. In many head and neck cancer patients, dysphagia, malnutrition and aspiration pneumonia are found and significantly impact on quality of life. Dysphagia is related to the tumor itself, or consequences of its treatment. A large number of surgical procedures, according to tumor site and extension, patient age, and general conditions, have been developed and are reviewed in this chapter. Swallowing disorders are related to both the surgical approach (open or endoscopic) and the tissue removed; while surgery for oral and oro-pharyngeal cancers mainly impact on oral control, oral peristalsis and mastication, partial laryngeal surgery interferes with airway protection mechanisms, and complete laryngeal removal may be complicated with hypopharyngeal strictures. Different chemo-radiotherapy protocols are available nowadays and are reviewed here; dysphagia may arise in the first two years or even many years afterwards and is mainly related to increased oro-pharyngeal transit time, reduced tongue and pharyngeal strength, restricted laryngeal and hyoid elevation, poor vestibule and true vocal fold closure and possibly abnormal upper esophageal sphincter function. The primary treatment goal of dysphagia in head and neck cancer patients is maintaining functional oral feeding and preventing aspiration and thoracic complications. All patients treated for a head and neck cancers should have access to a dysphagia specialist and to an instrumental investigation in order to establish adequate treatment.

Keywords

Neck Dissection Free Flap Neck Cancer Patient Laryngeal Carcinoma Total Laryngectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Antonio Schindler
    • 1
  • Francesco Mozzanica
    • 1
  • Filippo Barbiera
    • 2
  1. 1.Department of Biomedical and Clinical Sciences “L. Sacco”University of MilanMilanItaly
  2. 2.Unità Operativa di Radiologia “Domenico Noto”Azienda Ospedali Civili Riuniti “Giovanni Paolo II”SciaccaItaly

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