Xerostomia: 12‐Month changes in saliva production and its relationship to perception and performance of swallow function, oral intake, and diet after chemoradiation

Abstract

Reduced saliva weight does not correlate with slowed or inefficient swallow. Instead, reduced saliva weight seems to change patients' perceptions of their swallowing ability and, on that basis, their diet choices.

Physiological Changes to the Swallowing Mechanism Following (Chemo)radiotherapy for Head and Neck Cancer: A Systematic Review

“…This data is however only one part to the bigger question regarding prophylactic swallowing therapy. Ultimately, to fully understand (1) what parameters of the swallowing mechanism need to be targeted, (2) when is the optimal time to target these parameters, and (3) what are the most effective therapy tasks and methods of service delivery to habilitate them, ongoing research is required to validate and progress the results of the current study to optimise preventative swallowing exercise protocols in the future.…”

“…Whilst acute toxicities, including oedema, mucositis, pain and altered/thickened salivary flow, impair the swallowing mechanism in the short-term [1][2][3][4], radiation-induced tissue fibrosis and chronic oxidative stress perpetuate impairment to the deglutition musculature long after treatment has been completed [5][6][7]. These long-term swallowing complications can contribute to significant survivorship burden for HNC patients [8][9][10], resulting in detrimental impacts on psychosocial aspects of and participation in everyday life [11,12] and ultimately reduced quality of life [13,14].…”

Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation

“…Reduced tongue base retraction 51 (6) 94 (1) 96 (1) 74 (9) 83 (9) .01 * † Reduced tongue strength 23 (5) 77 (2) 50 (3) 30 (6) 33 (40) .03 * † Slowed/delayed vestibule closure 42 (8) 37 (3) 6 (1) 31 (5) 33 (5) .12 † Reduced tongue control/shaping 50 (14) 25 (4) 21 (5) 0 18 (4) <.01 * Reduced anteroposterior tongue movement 17 (11) 20 (4) 29 (5) 0 18 (4) .04 * Delayed pharyngeal swallow 17 (11) 26 (4) 35 ( 27 (5) 10 (7) 26 (5) <.01 * ‡ Reduced cricopharyngeal opening 0 4 (2) 17 (4) 5 (5) 18 ( .09…”

Patient assessed symptoms are poor predictors of objective findings. Results from a cross sectional study in patients treated with radiotherapy for pharyngeal cancer

“…Each structure has its own unique features of dose and volume sensitivity and resulting symptoms [1Á3]. Often symptoms from different organs interplay and result in serious handicaps that have detrimental consequences for the quality of life of the patients [4,5].…”