Assessment of swallowing function in patients with head and neck cancer

Difficulty in swallowing is a common complaint among patients with head and neck cancer. Preexistent dysphagia is often compounded by any of the side effects and sequelae of the current treatment modalities for malignancies of the head and neck. Surgery, radiotherapy, and chemoradiotherapy produce sensory and motor denervation and fibrosis of the upper aerodigestive tract musculature and mucosa. Clinicians must learn to anticipate and identify the various deficits of swallowing function in these patients. Flexible fiberoptic evaluation of swallowing and the modified barium swallow are critical tests for delineating the pathophysiology of these patients and establishing a protocol for their rehabilitation. Rehabilitation for patients with swallowing disorders decreases the morbidity of aspiration and allows for better nutrition, better hydration, and overall improvement in quality of life.