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Dysphagia following head and neck cancer surgery

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Abstract

Surgical resection of head and neck cancer results in predictable patterns of dysphagia and aspiration due to disruption of the anatomic structures of swallowing. Common procedures undertaken in the treatment of head and neck cancer include tracheostomy, glossectomy, mandibulectomy, surgery on the palate, total and partial laryngectomy, reconstruction of the pharynx and cervical esophagus, and surgery of the skull base. An overview is presented of normal swallowing physiology, as well as swallowing perturbations that are frequently encountered in postoperative head and neck cancer patients.

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References

  1. Lear CS: The frequency of deglutition in man. Arch Oral Biol 10:88–89, 1965

    Google Scholar 

  2. Logemann JA: Swallowing physiology and pathophysiology. In: Otolaryngol Clin North Am 21(4):613–623, 1988

  3. Carlson GW, Coleman JJ, Jurkiewicz MJ: Reconstruction of the hypopharynx and cervical esophagus. Current Probl Surg 30(5):425–480, 1993

    Google Scholar 

  4. McConnel FMS, Cerenko D, Mendelsohn MS: Manofluorographic analysis of swallowing. Otolaryngol Clin North Am 21(4):625–636, 1988

    Google Scholar 

  5. Seiden AM: Esophageal disorders. In: Paparella MM, Shumrick DA, Gluckman JL, Meyerhoff WL (eds.). Otolaryngology, 3rd ed. Philadelphia: WB Saunders, 1991

    Google Scholar 

  6. Bonanno PC: Swallowing dysfunction after tracheotomy. Ann Surg 174:29–33, 1971

    Google Scholar 

  7. Cameron JL, Reynolds J, Zuidema GD: Aspiration in patients with tracheostomies. Surg Gynecol Obstet 136:68–70, 1973

    Google Scholar 

  8. Bone DK, Davis JL, Zuidema GD, Cameron JL: Aspiration pneumonia, Ann Thorac Surg 18:30–37, 1974

    Google Scholar 

  9. Nash M: Swallowing problems in the tracheotomized patient. Otolaryngol Clin North Am 21(4):701–709, 1988

    Google Scholar 

  10. McConnel FMS, Teichgraeber JF, Adler RK: A comparison of three methods of oral reconstruction. Arch Otolaryngol Head Neck Surg 113:496–500, 1987

    Google Scholar 

  11. Hirano M, Kuroiwa Y, Tanaka S, Matsuoka H, Sato K, Yoshida T: Dysphagia following various degrees of surgical resection for oral cancer. Ann Otol Rhinol Laryngol 101:138–142, 1992

    Google Scholar 

  12. Conley JJ: Swallowing dysfunctions associated with radical surgery of the head and neck. AMA Arch Surg 80:602–612, 1960

    Google Scholar 

  13. Pauloski BR, Logemann JA, Rademaker AW, McConnel FM, Heiser MA, Cardinale S, Shedd D, Lewin J, Baker SR, Graner D, Cook B, Milianti F, Collins S, Baker T: Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction. J Speech Hear Res 36: 267–276, 1993

    Google Scholar 

  14. Weber RS, Ohlms L, Bowman J, Jacob R, Goepfert H: Functional results after total or near total glossectomy with laryngeal preservation. Arch Otolaryngol Head Neck Surg 117:512–516, 1991

    Google Scholar 

  15. Logemann JA, Bytell DE: Swallowing disorders in three types of head and neck surgical patients. Cancer 44:1095–1105, 1979

    Google Scholar 

  16. Hurst PS: The role of the prosthodontist in the correction of swallowing disorders. Otolaryngol Clin North Am 21(4): 771–780, 1988

    Google Scholar 

  17. Urken ML, Buchbinder D, Weinberg H, Vickery C, Sheiner A, Parker R, Schaefer J, Som P, Shapiro A, Lawson W, Biller HF: Functional evaluation following microvascular oromandibular reconstruction of the oral cancer patient: a comparative study of reconstructed and nonreconstructed patients. Laryngoscope 101: 935–950, 1991

    Google Scholar 

  18. Urken ML: Composite free flaps in oromandibular reconstruction. Arch Otolaryngol Head Neck Surg 117:724–732, 1991

    Google Scholar 

  19. Johnson JT, Aramany MA, Myers EN: Palatal neoplasms: reconstruction considerations. Otolaryngol Clin North Am 16: 441–456, 1983

    Google Scholar 

  20. Balfe DM, Koehler RE, Setzen M, Weyman PJ, Baron RL, Ogura JH: Barium examination of the esophagus after total laryngectomy. Radiology 143:501–508, 1982

    Google Scholar 

  21. Nayar RC, Sharma VP, Arora MML: A study of the pharynx after laryngectomy. J Laryngol Otol 98:807–810, 1984

    Google Scholar 

  22. McConnel FMS, Mendelsohn MS, Logemann JA: Examination of swallowing after total laryngectomy using manofluorography. Head Neck Surg 9:3–12, 1986.

    Google Scholar 

  23. McConnel FMS, Cerenko D, Mendelsohn MS: Dysphagia after total laryngectomy. Otolaryngol Clin North Am 21(4):721–726, 1988

    Google Scholar 

  24. Kaplan JN, Dobie RA, Cummings CW: The incidence of hypopharyngeal stenosis after surgery for laryngeal cancer. Otolaryngol Head Neck Surg 89:956–959, 1981

    Google Scholar 

  25. Jung TTK, Adams GL: Dysphagia in laryngectomized patients. Otolaryngol Head Neck Surg 88:25–33, 1980

    Google Scholar 

  26. Kirchner JA, Scatliff JH, Dey FL, Shedd DP: The pharynx after laryngectomy—changes in its structure and function. Laryngoscope 73:18–33, 1963

    Google Scholar 

  27. Baek SM, Lawson W, Biller HF: Reconstruction of hypopharynx and cervical esophagus with pectoralis major island myocutaneous flap. Ann Plast Surg 7:18–25, 1981

    Google Scholar 

  28. Baek SM, Lawson W, Biller HF: An analysis of 133 pectoralis major myocutaneous flaps. Plast Reconstr Surg 69:460–467, 1982

    Google Scholar 

  29. Theogaraj SD, Merritt WH, Acharya G, Cohen IK: The pectoralis major myocutaneous island flap in single-stage reconstruction of the pharyngoesophageal region. Plast Reconstr Surg 65: 267–271, 1980

    Google Scholar 

  30. Watson JS, Robertson GA, Lendrum J, Stranc MF, Pohl MJ: Pharyngeal reconstruction using the latissimus dorsi myocutaneous flap. Br J Plast Surg 35(4):401–407, 1982

    Google Scholar 

  31. Schuller DE: Pectoralis myocutaneous flap in head and neck reconstruction. Arch Otolaryngol 109:185–189, 1983

    Google Scholar 

  32. Wei WI, Lam KH, Choi S, Wong J: Late problems after pharyngolaryngoesophagectomy and pharyngogastric anastomosis for cancer of the larynx and hypopharynx. Am J Surg 148(4):509–513, 1984

    Google Scholar 

  33. Theile DE, Robinson DW, McCafferty GJ: Pharyngolaryngectomy reconstruction by revascularized free jejunal graft. Aust N Z J Surg 56(11):849–852, 1986

    Google Scholar 

  34. Harrison DF, Thompson AE: Pharyngolaryngoesophagectomy with pharyngogastric anastomosis for cancer of the hypopharynx: review of 101 operations. Head Neck Surg 8(6):418–428, 1986

    Google Scholar 

  35. Meyers WC, Seigler HF, Hanks JB, Thompson WM, Postlethwait R, Jones RS, Akwari OK, Cole TB: Postoperative function of “free” jejunal transplants for replacement of the cervical esophagus. Ann Surg 192(4):439–448, 1992

    Google Scholar 

  36. Carlson GW, Schusterman MA, Guillamondegui OM: Total reconstruction of the pharynx and cervical esophagus: a 20-year experience. Ann Plast Surg 29(5):408–412, 1992

    Google Scholar 

  37. McConnel FMS, Hester TR, Mendelsohn MS, Logemann JA: Manofluorography of deglutition after total laryngopharyngectomy. Plast Reconstr Surg 81(3):346–351, 1988

    Google Scholar 

  38. Code CF, Hightower NC, Morlock CG: Motility of the alimentary canal in man: review of recent studies. Am J Med 13:328–350, 1952

    Google Scholar 

  39. Sokol EM, Heitmann P, Wolf BS, Cohen BR: Simultaneous cineradiographic and manometric study of the pharynx, hypopharynx, and cervical esophagus. Gastroenterology 51(6): 960–974, 1966

    Google Scholar 

  40. Schoenrock LD, King AY, Everts EC, Schneider HJ, Shumrick D: Hemilaryngectomy: deglutition evaluation and rehabilitation. Trans Am Acad Ophth & Otol 76:752–757, 1972

    Google Scholar 

  41. Weaver AW, Fleming SM: Partial laryngectomy: analysis of associated swallowing disorders. Am J Surg 136:486–489, 1978

    Google Scholar 

  42. Hirano M, Kurita S, Tateishi M, Matsuoka H: Deglutition following supraglottic horizontal laryngectomy. Ann Otol Rhinol Laryngol 96:7–11, 1987

    Google Scholar 

  43. Flores TC, Wood BG, Levine HL, Koegel L Jr, Tucker HM: Factors in successful deglutition following supraglottic laryngeal surgery. Ann Otol Rhinol Laryngol 91:579–583, 1982

    Google Scholar 

  44. McConnel FMS, Mendelsohn MS, Logemann JA: Manofluorography of deglutition after supraglottic laryngectomy. Head Neck Surg 9:142–150, 1987

    Google Scholar 

  45. Litton WB, Leonard JR: Aspiration after partial laryngectomy: cinefluorographic studies. Laryngoscope 79:887–908, 1969

    Google Scholar 

  46. Staple TW, Ogura JH: Cineradiography of the swallowing mechanism following subtotal supraglottic laryngectomy. Radiology 87:226–230, 1966

    Google Scholar 

  47. Freeman RB, Marks JE, Ogura JH: Voice preservation in treatment of carcinoma of the pyriform sinus. Laryngoscope 89(11): 1855–1863, 1979

    Google Scholar 

  48. Levine TM: Swallowing disorders following skull base surgery. Otolaryngol Clin North Am 21(4):751–759, 1988

    Google Scholar 

  49. Jennings KS, Siroky D, Jackson CG: Swallowing problems after excision of tumors of the skull base: diagnosis and management in 12 patients. Dysphagia 7:40–44, 1992

    Google Scholar 

  50. Fisch U: Infratemporal fossa approach to tumours of the temporal bone and base of the skull. J Laryngol Otol 92(11):949–967, 1978

    Google Scholar 

  51. Biller HF, Shugar JM, Krespi YP: A new technique for wide-field exposure of the base of the skull. Arch Otolaryngol 107(11):698–702, 1981

    Google Scholar 

  52. Smith PG, Sharkey DE: Experience with the resection of parapharyngeal cancers via the infratemporal fossa approach. Otolaryngol Head Neck Surg 94(3):291–301, 1986

    Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University of Colorado Health Sciences Center, Denver, Colorado, USA

    Michael B. Kronenberger MD & Arlen D. Meyers MD, MBA

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  1. Michael B. Kronenberger MD
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  2. Arlen D. Meyers MD, MBA
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Kronenberger, M.B., Meyers, A.D. Dysphagia following head and neck cancer surgery. Dysphagia 9, 236–244 (1994). https://doi.org/10.1007/BF00301917

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