Swallowing and Tongue Function Following Treatment for Oral and Oropharyngeal Cancer

Abstract

This study examined tongue function and its relation to swallowing in 13 subjects with oral or oropharyngeal cancer treated with primary radiotherapy +/- chemotherapy and 13 age- and sex-matched control subjects. Measures of swallowing and tongue function were obtained using videofluoroscopy, pretreatment and 2 months posttreatment. Maximum isometric strength and endurance at 50% of maximum strength were obtained with the Iowa Oral Performance Instrument (IOPI). Control subjects were tested once. All subjects with head and neck cancer were evaluated pretreatment and 2 months posttreatment. No significant differences were found for the tongue function measures pre- and 2 months posttreatment in the group with head and neck cancer. Significantly higher tongue strength was observed in the control than in the group with head and neck cancer both pre- and posttreatment. No significant differences were found for the 2 groups for tongue endurance measures. Significant correlations of tongue strength and endurance and some swallow measures were found pre- and posttreatment for the group with head and neck cancer and for the control group. These correlations included oral and pharyngeal temporal swallow measures and oropharyngeal swallow efficiency. Pretreatment differences between the 2 groups in tongue strength were likely related to tumor bulk, pain, and soreness. Two-month posttreatment differences were likely related to radiation +/- chemotherapy changes to the oral and pharyngeal mucosa. This study provides support for the hypothesis that tongue strength plays a role in oropharyngeal swallowing, particularly related to the oral phase of the swallow.

Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers

“…Additionally, not all patients were able to swallow two trials of each food consistency, or the speech-language pathologist may have judged it risky to introduce or continue with a specific consistency during the VFG study. The swallowing dysfunctions observed in our study are similar to the ones reported by Lazarus et al [36,37] following chemotherapy ϩ radiation for the treatment of head and neck cancers. Impaired swallowing motility may be the result of edema, fibrosis, and reduced salivary flow caused by radiation and chemotherapy.…”

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

“…Many tongue and swallowing exercises, such as tongue function therapy and swallowing maneuvres, are described in the literature [17,21,48,[97][98][99][100][101][102]. Furthermore, the eVectiveness of these swallowing exercises has not yet been assessed systematically in the CRT patient population.…”

Head and Neck Cancer: Changes in Artrokinematic Parameters of Neck and Swallowing Function after Radiotherapy

“…2,9,[14][15][16][17] Decreased tongue mobility and strength, impairment in bolus preparation and transport, increased oral residue were described as oral phase disorders. 15,18,19 Delayed triggering swallowing reflex, impairment in velopharyngeal closure, decreased tongue base retraxion, pharyngeal contraction, hyolaryngeal elevation, airway closure, upper esophageal sphincter (UOS) opening and increased residue in tongue base, vallecula, pharynx and pyriform sinus were determined as phryngeal disorders after RT.…”