Skip to main content
SpringerLink
Log in

Impact of Communication and Swallowing Dysfunction

  • Chapter
  • First Online:
Head and Neck Cancer

  • 668 Accesses

Abstract

Head and neck cancer, as well as the treatment for head and neck cancer, can result in communication and swallowing dysfunction before and during treatment, as well as throughout survivorship. This chapter provides a detailed overview of the impact these dysfunctions can have on an individual patient’s well-being and quality of life (QOL). Key elements of psychological well-being and quality of life are defined. Risk factors for dysfunction and reduced quality of life are outlined, as well as methods for identifying QOL decline. The physiology of normal speech production and swallowing are described. Causes and symptoms of dysphonia, aphonia, dysphagia, and dysarthria are detailed, along with their potential psychosocial effects. The role of the speech-language pathologist is described, along with the importance of multidisciplinary care, therapeutic counseling, and support groups.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Salvador-Carulla L, Lucas R, Luis Ayuso-Mateos J, Miret M. Use of the terms “Wellbeing” and “Quality of Life” in health sciences: a conceptual framework. Eur J Psychiatr. 2014;28(1). https://doi.org/10.4321/S0213-61632014000100005.

    Article  Google Scholar 

  2. Ryff C, Reyes C. The structure of psychological well-being revisited. J Pers Soc Psychol. 1995;69(4):719–27.

    Article  CAS  PubMed  Google Scholar 

  3. Berridge K, Kringelbach M. Pleasure systems in the brain. Neuron. 2015;86(3):646–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Linkov G, Ebersole B, Jamal N. Section 4, Chapter 15: Dysphagia. In: Kennedy DW, Toskala E, editors. ENT essentials. Philadelphia: Jaypee; 2017.

    Google Scholar 

  5. Matsuo K, Palmer JB. Anatomy and physiology of feeding and swallowing – normal and abnormal. Phys Med Rehabil Clin N Am. 2008;19(4):691–707.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Frowen J, Cotton S, Corry J, Perry A. Impact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancer. Head Neck. 2009;32(4):513–28.

    Google Scholar 

  7. Caudell JJ, Schaner PE, Meredith RF, Locher JL, Nabell LM, Carroll WR, Magnuson JS, Spencer SA, Bonner JA. Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2009;73(2):410–5. https://doi.org/10.1016/j.ijrobp.2008.04.048. Epub 2008 Jul 16.

    Article  PubMed  Google Scholar 

  8. Dale T, Hutcheson K, Mohamed A, et al. Beyond mean pharyngeal constrictor dose for beam path toxicity in non-target swallowing muscles: dose-volume correlates of chronic radiation associated dysphagia (RAD) after oropharyngeal intensity modulated therapy. Radiother Oncol. 2016;118:304–14.

    Article  Google Scholar 

  9. Starmer H, Quon H, Kumar R, Alcorn S, Murano E, Jones B, Humbert I. The effect of radiation dose on swallowing: evaluation of aspiration and kinematics. Dysphagia. 2015;30:430–7.

    Article  PubMed  Google Scholar 

  10. Vlacich G, Spratt DE, Diaz R, Phillips JG, Crass J, Li CI, Shyr Y, Cmelak AJ. Dose to the inferior pharyngeal constrictor predicts prolonged gastrostomy tube dependence with concurrent intensity-modulated radiation therapy and chemotherapy for locally-advanced head and neck cancer. Radiother Oncol. 2014;110(3):435–40.

    Article  PubMed  Google Scholar 

  11. Hutcheson KA, Bhayani MK, Beadle BM, Gold KA, Shinn EH, Lai SY, Lewin J. Eat and exercise during radiotherapy or chemoradiotherapy for pharyngeal cancers: use it or lose it. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1127–34.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Holloway R, Hellewell J, Marbella A, Layde P, Myers K, Cambell B. Psychological effects in long term head and neck cancer survivors. Head Neck. 2005. (www.interscience.wiley.com). https://doi.org/10.1002/hed.20147.

    Article  Google Scholar 

  13. Eadie T, Faust L, Bolt S, Kapsner-Smith M, Pompon R, Baylor C, Futran N, Mendez E. Role of psychosocial factors on communicative participation among survivors of head and neck cancer. Otolaryngol Head Neck Surg. 2018;159(2):266–73.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Williams A, Lindholm J, Siddiqui F, Ghanem T, Chang S. Clinical assessment of cognitive function in patients with head and neck cancer: prevalence and correlates. Otolaryngol Head Neck Surg. 2017;157(5):808–15.

    Article  PubMed  Google Scholar 

  15. Merrill RM, Roy N, Lowe J. Voice-related symptoms and their effects of quality of life. Ann Otol Rhinol Laryngol. 2013;122(6):404–11.

    Article  PubMed  Google Scholar 

  16. Ebersole B, Soni R, Lango M, Moran K, Jamal N. The influence of occupation on self-perceived vocal problems in patient’s with voice complaints. J Voice. 2017; https://doi.org/10.1016/j.jvoice.2017.08.028. [Epub ahead of print].

    Article  PubMed  Google Scholar 

  17. Devins GM, Stam HJ, Koopmans JP. Psychosocial impact of laryngectomy mediated by perceived stigma and illness intrusiveness. Can J Psychiatr. 1994;39(10):608–16.

    Article  CAS  Google Scholar 

  18. Lebel S, Castonguay M, Mackness G, Irish J, Bezjak A, Devins GM. The psychosocial impact of stigma in people with head and neck or lung cancer. Psychooncology. 2013;22(1):140–52. https://doi.org/10.1002/pon.2063. Epub 2011 Sep 19.

    Article  PubMed  Google Scholar 

  19. Perry A, Casey E, Cotton S. Quality of life after total laryngectomy: functioning, psychological well-being and self-efficacy. Int J Lang Commun Disord. 2015;50(4):467–75.

    Article  PubMed  Google Scholar 

  20. Salturk Z, Arslanoglu A, Ozdemir E, et al. How do voice restoration methods affect the psychological status of patients after total laryngectomy? HNO. 2016;3:163–8.

    Article  Google Scholar 

  21. Williams SE, Scanio TS, Ritterman SI. Temporal and perceptual characteristics of tracheoesophageal voice. Laryngoscope. 1989;99:846.

    Article  CAS  PubMed  Google Scholar 

  22. Van Sluis KE, van der Molen L, can Son RJJH, et al. Objective and subjective voice outcomes after total laryngectomy: a systematic review. Eur Arch Otorhinolaryngol. 2018;275:11–26.

    Article  PubMed  Google Scholar 

  23. Robbins J. Acoustic differentiation of laryngeal, esophageal, and tracheoesophageal speech. J Speech Hear Res. 1984;27:577.

    Article  CAS  PubMed  Google Scholar 

  24. Hutcheson K, Lewin J, Strugis E, et al. Enlarged tracheoesophageal puncture after total laryngectomy: a systematic review and meta-analysis. Head Neck. 2011;33(1):20–30.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hutcheson K, Lewin J, Sturgis E, et al. Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy. Head Neck. 2012;10(1002):557–64.

    Article  Google Scholar 

  26. Singer S, Wollbruck D, Dietz A, et al. Speech rehabilitation during the first year after total laryngectomy. Head Neck. 2013;35:1583–90.

    Article  PubMed  Google Scholar 

  27. Tiple C, Drugan T, Dinescu FV, et al. The impact of vocal rehabilitation on quality of life and voice handicap in patients with total laryngectomy. J Res Med Sci. 2016;21:127. https://doi.org/10.4103/1735-1995.196609.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hogikyan ND, Sethuraman G. Validation of an instrument to measure voice-related quality of life (V-RQOL). J Voice. 1999;13(4):557–69.

    Article  CAS  PubMed  Google Scholar 

  29. Rosen CA, Lee AS, Osborne J, et al. Development and validation of the voice handicap index-10. Laryngoscope. 2004;114(9):1549–56.

    Article  PubMed  Google Scholar 

  30. Piacentini V, Zuin A, Cattaneo D, Schindler A. Reliability and validity of an instrument to measure quality of life in the dysarthric speaker. Folia Phoniatr Logop. 2011;63(6):289–95.

    Article  PubMed  Google Scholar 

  31. McHorney CA, Robbins J, Lomax K, et al. The swal-qol and swal-care outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17(2):97–114.

    Article  PubMed  Google Scholar 

  32. Chen AY, Frankowski R, Bishop-Leone J. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M.D. Anderson dysphagia inventory. Arch Orolaryngol Head Neck Surg. 2001;127(7):870–6.

    CAS  Google Scholar 

  33. Belafsky PC, Mouadeb DA, Rees CJ, et al. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.

    Article  PubMed  Google Scholar 

  34. List MA, C’Antonio LL, Cella DF, et al. The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy-head and neck scale. A study of utility and validity. Cancer. 1996;77(11):2294–301.

    Article  CAS  PubMed  Google Scholar 

  35. Murphy BA, Dietrick MS, Wells N, et al. Reliability and validity of the Vanderbilt head and neck symptom survey: a tool to assess symptom burden in patients treated with chemoradiation. Head Neck. 2010;32(1):36–7.

    Google Scholar 

  36. Bjordal K, Hammerlid E, Ahlner-Elmgvist M, et al. Quality of life in head and neck cancer patients: validation of the European organization for research and treatment of cancer quality of life questionnaire-h&n35. J Clin Oncol. 1999;17(3):1008–19.

    Article  CAS  PubMed  Google Scholar 

  37. Stachler RJ, Crancis DO, Schwartz SR, et al. Clinical practice guideline: hoarseness (dysphonia) (update). Otolaryngol Head Neck Surg. 2019;158:S1–S42.

    Article  Google Scholar 

  38. Scott S, Robinson K, Wilson JA, Mackenzie K. Patient-reported problems associated with dysphonia. Clin Otolaryngol Allied Sci. 1997;22(1):37–40.

    Article  CAS  PubMed  Google Scholar 

  39. Krische S, Weigelt S, Hoppe U, et al. Quality of life in dysphonic patients. J Voice. 2005;19(1):132–7.

    Article  Google Scholar 

  40. Devins G, Bezjack A, Mah K, Loblaw D, Gotowiec A. Context moderates illness-induced lifestyle disruptions across life domains: a test of the illness intrusiveness theoretical framework in six common cancers. Psycho-Oncology. 2005;15(3):221–33.

    Article  Google Scholar 

  41. Eadie TL, Bowker BC. Coping and quality of life after total laryngectomy. Otolaryngol Head Neck Surg. 2012;146(6):959–65.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Enderby P. Disorders of communication: dysarthria. Handb Clin Neurol. 2013;110:273–81.

    Article  PubMed  Google Scholar 

  43. Logemann JA. Dysphagia: evaluation and treatment. Folio Phoniatr Logop. 1995;47:140–64.

    Article  CAS  Google Scholar 

  44. Francis DO, Weymuller EA Jr, Parvathaneni U, et al. Dysphagia, stricture, and pneumonia in head and neck cancer patients: does treatment modality matter? Ann Otol Rhinol Laryngol. 2010;119:391–7.

    Article  PubMed  Google Scholar 

  45. McBride SM, Paramni RJ, Jang JW, et al. Intensity-modulated versus conventional radiation therapy for oropharyngeal carcinoma: long-term dysphagia and tumor control outcomes. Head Neck. 2014;36:492–8.

    Article  PubMed  Google Scholar 

  46. Hutcheson KA, Lewin JS, Barringer DA, et al. Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer. 2012;118(23):5793–9.

    Article  PubMed  Google Scholar 

  47. Chen AM, Bao-Qing L, Jennelle RLS, et al. Late esophageal toxicity after radiation therapy for head and neck cancer. Head Neck. 2010;32(2):178–83.

    PubMed  Google Scholar 

  48. Chen AM, Li BQ, Lau DH, et al. Evaluating the role of prophylactic gastrostomy tube placement prior to definitive chemoradiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2010;78:1026.

    Article  PubMed  Google Scholar 

  49. Ahlberg A, al-Abany M, Alevronta E, et al. Esophageal stricture after radiotherapy in patients with head and neck cancer: experience of a single institution over 2 treatment periods. Head Neck. 2010;32:452.

    PubMed  Google Scholar 

  50. Carmignani I, Locatello LG, Desider I, et al. Analysis of dysphagia in advanced-stage head-and-neck cancer patients: impact on quality of life and development of a preventative swallowing treatment. Eur Arch Otorhinolaryngol. 2018;275(8):2159–67.

    Article  PubMed  Google Scholar 

  51. Chen SC, Huang BS, Hung TM, et al. Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs. 2018;36:89–94.

    Article  PubMed  Google Scholar 

  52. Wells M, Swartzman S, Lang H, et al. Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer. 2016;24(6):2463–72.

    Article  PubMed  Google Scholar 

  53. Andrade MS, Goncalves AN, Guedes RL, et al. Correlation between swallowing-related quality of life and videofluoroscopy after head and neck cancer treatment. Codas. 2017;29(1):e20150175.

    PubMed  Google Scholar 

  54. Moloney K, Walshe M. Managing and supporting quality-of-life issues in dysphagia: a survey of clinical practice patterns and perspectives in the UK, Ireland, and South Africa. Int J Lang Commun Disord. 2018; [Epub ahead of print].

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Division of Head and Neck Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA

    Barbara Ebersole

  2. Division of Head and Neck Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA

    Kathleen Moran

Authors
  1. Barbara Ebersole
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kathleen Moran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara Ebersole .

Editor information

Editors and Affiliations

  1. Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, USA

    Christopher E. Fundakowski

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ebersole, B., Moran, K. (2020). Impact of Communication and Swallowing Dysfunction. In: Fundakowski, C. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-27881-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-27881-6_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27880-9

  • Online ISBN: 978-3-030-27881-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation