[Swallowing after chemotherapy and radiotherapy for laryngeal and hypopharyngeal carcinomas]

Abstract

The main goals of the larynx preservation protocol are eradication of cancer and preservation of a functional larynx with maintenance of respiration, phonation and swallowing. Few studies, however have addressed functional outcomes. OBJECTIVE: Functional evaluation of oropharyngeal swallowing in patients enrolled in a larynx preservation protocol at the Hospital do Cancer AC Camargo. METHODS: Evaluation of swallowing was performed by videofluoroscopy in 31 patients, focusing on: oropharyngeal motility disorders, stasis, laryngeal penetration, aspiration and severity of dysphagia. RESULTS: Swallowing analysis: 5 patients showed inefficient bolus preparation, 14 had changes in the bolus propulsion; 23 patients had a reduced laryngeal elevation, 26 presented with stasis in the vallecula and 14 with stasis in hypopharynx. Nine patients presented silent aspiration. We detected functional swallowing in 11 patients; mild dysphagia in 7; mild/moderate in 7; moderate in 3 and severe dysphagia in 3. CONCLUSION: Larynx preservation results in changes of swallowing, ranging in their majority from discrete to moderate. Some patients, however, developed severe dysphagia, and oral feeding was not possible.