Laryngeal sensation and pharyngeal delay time after (chemo)radiotherapy

Eur Arch Otorhinolaryngol. 2014 Aug;271(8):2299-304. doi: 10.1007/s00405-013-2775-7. Epub 2013 Oct 23.

Abstract

The objective of the study was to evaluate the association between changes in laryngeal sensation and initiation of swallowing reflex or swallowing function before and after (chemo)radiotherapy. A prospective study was conducted in a tertiary referral university hospital. Thirteen patients who received (chemo)radiotherapy for treatment of laryngeal or hypopharyngeal cancer were included. Laryngeal sensation was evaluated at the tip of the epiglottis before and 1, 3 months, and 1 year after (chemo)radiotherapy. Videofluoroscopy was performed at the same time. Quantitative determinations included changes in laryngeal sensation, computed analysis of pharyngeal delay time, the distance and velocity of hyoid bone movement during the phase of hyoid excursion, and pharyngeal residue rate (the proportion of the bolus that was left as residue in the pharynx at the first swallow). Laryngeal sensation significantly deteriorated 1 month after (chemo)radiotherapy, but there was a tendency to return to pretreatment levels 1 year after treatment. Neither pharyngeal delay time nor displacement of the hyoid bone changed significantly before and after (chemo)radiotherapy. In addition, there was no significant difference in the mean velocity of hyoid bone movement and the amount of stasis in the pharynx at the first swallow before and after (chemo)radiotherapy. After (chemo)radiotherapy, laryngeal sensation deteriorated. But, in this study, videofluoroscopy showed that swallowing reflex and function were maintained.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / radiotherapy*
  • Chemoradiotherapy
  • Deglutition
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Laryngeal Nerves / drug effects
  • Laryngeal Nerves / physiopathology*
  • Laryngeal Nerves / radiation effects
  • Larynx / drug effects
  • Larynx / physiopathology*
  • Larynx / radiation effects
  • Male
  • Middle Aged
  • Pharynx / innervation*
  • Pharynx / physiopathology
  • Pharynx / radiation effects
  • Prospective Studies
  • Sensation / radiation effects*
  • Squamous Cell Carcinoma of Head and Neck
  • Time Factors