Dysphagia and head and neck cancer: how tumors and their treatments impact swallowing
Mariana Gonçalves Rodrigues, Eliézia Helena de Lima Alvarenga, Leonardo Haddad
Abstract
Introduction: Dysphagia manifests in various ways in patients with head and neck cancer. It can be an initial symptom of the oncological disease or a consequence of the treatment received. Objective: This study aims to review the impact of dysphagia on the different sites where head and neck cancer occurs, including the mouth, pharynx, larynx, and thyroid. Methods: A comprehensive search was conducted in the PubMed database using the following terms: “dysphagia and oral cancer”; “dysphagia and oropharyngeal cancer”; “dysphagia and laryngeal or hypopharyngeal cancer”; “dysphagia and larynx cancer”; “dysphagia and thyroid”, and “dysphagia and neck dissection”. Results: The changes in swallowing physiology resulting from head and neck cancer or its treatments were analyzed by anatomical subsite. Outcomes were also evaluated separately based on the treatment modality, either surgical or non-surgical. Conclusion: Dysphagia affects not only the quality of life but also contributes to the deterioration of physical health.
Keywords
References
1. Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50–79-year-old men and women in an urban population. Dysphagia. 1991;6(4):187-92. PMid:1778094.
2. Reddy SS, Priyadharshini R. Oropharyngeal dysphagia: understanding the etiology. Otolaryngol Res. 2017;1:115.
3. Sasegbon A, Hamdy S. The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia. Neurogastroenterol Motil. 2017;29(11):e13100. http://dx.doi.org/10.1111/nmo.13100 PMid:28547793.
4. Roden DF, Altman KW. Causes of dysphagia among different age groups: a systematic review of the literature. Vol. 46. Otolaryngol Clin North Am. 2013;46(6):965-87. http://dx.doi.org/10.1016/j.otc.2013.08.008. PMid:24262954.
5. Smith PA. Nutrition, hydration, and dysphagia in long-term care: differing opinions on the effects of aspiration. J Am Med Dir Assoc. 2006;7(9):545-9. http://dx.doi. org/10.1016/j.jamda.2006.03.008. PMid:17095418.
6. Jean A. Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev. 2001;81(2):929-69. http://dx.doi.org/10.1152/ physrev.2001.81.2.929. PMid:11274347.
7. Leopold NA, Kagel MC. Dysphagia—ingestion or deglutition?: A proposed paradigm. Dysphagia. 1997;12(4):202-6. http://dx.doi.org/10.1007/PL00009537 PMid:9294940.
8. Martin BJ, Logemann JA, Shaker R, Dodds WJ. Coordination between respiration and swallowing: respiratory phase relationships and temporal integration. J Appl Physiol. 1994;76(2):714-23. http://dx.doi.org/10.1152/jappl.1994.76.2.714 PMid:8175582.
9. Krebbers I, Pilz W, Vanbelle S, Verdonschot RJCG, Baijens LWJ. Affective symptoms and oropharyngeal dysphagia in head-and-neck cancer patients: a systematic review. Dysphagia. 2023;38(1):127-44. http://dx.doi.org/10.1007/s00455-022- 10484-8. PMid:35796877.
10. Russi EG, Corvo R, Merlotti A, Alterio D, Franco P, Pergolizzi S, De Sanctis V, Ruo Redda MG, Ricardi U, Paiar F, Bonomo P, Merlano MC, Zurlo V, Chiesa F, Sanguineti G, Bernier J. Swallowing dysfunction in head and neck cancer patients treated by radiotherapy: Review and recommendations of the supportive task group of the Italian Association of Radiation Oncology. Cancer Treat Rev. 2012;38(8):1033-49. http://dx.doi.org/10.1016/j.ctrv.2012.04.002. PMid:22542950.
11. Dwivedi RC, St Rose S, Chisholm EJ, Georgalas C, Bisase B, Amen F, Kerawala CJ, Clarke PM, Nutting CM, Rhys-Evans PH, Harrington KJ, Kazi R. Evaluation of swallowing by Sydney Swallow Questionnaire (SSQ) in oral and oropharyngeal cancer patients treated with primary surgery. Dysphagia. 2012;27(4):491-7. http:// dx.doi.org/10.1007/s00455-012-9395-z. PMid:22350113. Rodrigues et al. Arch Head Neck Surg. 2023;52:e20230009.
12. Chaves ALF, Marta GN, Kowalski LP. Manual de oncologia em cabeça e pescoço. São Paulo: Âmbito; 2021
13. Dawson C, Al-Qamachi L, Martin T. Speech and swallowing outcomes following oral cavity reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2017;25(3):200-4. http://dx.doi.org/10.1097/MOO.0000000000000359. PMid:28459758.
14. Zhang J, Li Q, Wu HY, Yang Y. A Systematic review of swallowing training measures for postoperative oral cancer patients. Dysphagia. 2022;37(6):1839-50. http:// dx.doi.org/10.1007/s00455-022-10445-1. PMid:35435477.
15. Kao SS, Peters MD, Krishnan SG, Ooi EH. Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: a systematic review. Laryngoscope. 2016;126(7):1572-
80. http://dx.doi.org/10.1002/lary.25894. PMid:26865034.
16. Giannitto C, Preda L, Zurlo V, Funicelli L, Ansarin M, Di Pietro S, Bellomi M. Swallowing disorders after oral cavity and pharyngolaryngeal surgery and role of imaging. Gastroenterol Res Pract. 2017;2017:7592034. http://dx.doi. org/10.1155/2017/7592034. PMid:28496456.
17. Togni L, Mascitti M, Vignigni A, Alia S, Sartini D, Barlattani A, Emanuelli M, Santarelli A. Treatment-related dysgeusia in oral and oropharyngeal cancer: a comprehensive review. Nutrients. 2021;13(10):3325. http://dx.doi.org/10.3390/ nu13103325. PMid:34684326.
18. Levi LE, Lalla RV. Dental treatment planning for the patient with oral cancer. Dent Clin North Am. 2018;62(1):121-30. http://dx.doi.org/10.1016/j.cden.2017.08.009. PMid:29126489.
19. Wall LR, Ward EC, Cartmill B, Hill AJ. Physiological changes to the swallowing mechanism following (chemo)radiotherapy for head and neck cancer: a systematic review. Dysphagia. 2013;28(4):481-93. http://dx.doi.org/10.1007/s00455-013- 9491-8. PMid:24078216.
20. Bressan V, Stevanin S, Bianchi M, Aleo G, Bagnasco A, Sasso L. The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: a systematic review. Cancer Treat Rev. 2016;45:105-19. http://dx.doi.org/10.1016/j. ctrv.2016.03.006. PMid:27010487.
21. Anakapu K, Wilson M, Findlay M, Brown T, Bauer J. Nutritional outcomes in patients undergoing transoral robotic surgery for head and neck cancers compared to conventional open surgery. Systematic review. Head Neck. 2022;44(1):238-53. http://dx.doi.org/10.1002/hed.26913. PMid:34724253.
22. Hutcheson KA, Holsinger FC, Kupferman ME, Lewin JS. Functional outcomes after TORS for oropharyngeal cancer: a systematic review. Functional outcomes after TORS for oropharyngeal cancer: a systematic review. Eur Arch Otorhinolaryngol. 2015;272(2):463-71. http://dx.doi.org/10.1007/s00405-014-2985-7 PMid:24643851.
23. Li P, Constantinescu GC, Nguyen NA, Jeffery CC. Trends in reporting of swallowing outcomes in oropharyngeal cancer studies: a systematic review. Dysphagia. 2020;35(1):18-23. http://dx.doi.org/10.1007/s00455-019-09996-7. PMid:30847548. Rodrigues et al. Arch Head Neck Surg. 2023;52:e20230009.
24. Høxbroe Michaelsen S, Grønhøj C, Høxbroe Michaelsen J, Friborg J, von Buchwald C. Quality of life in survivors of oropharyngeal cancer: a systematic review and meta-analysis of 1366 patients. Eur J Cancer. 2017;78:91-102. http://dx.doi. org/10.1016/j.ejca.2017.03.006 PMid:28431302.
25. Giannitto C, Preda L, Zurlo V, Funicelli L, Ansarin M, Di Pietro S, Bellomi M. Swallowing disorders after oral cavity and pharyngolaryngeal surgery and role of imaging. Gastroenterol Res Pract. 2017;2017:7592034. http://dx.doi. org/10.1155/2017/7592034. PMid:28496456.
26. Roets E, Tukanova K, Govarts A, Specenier P. Quality of life in oropharyngeal cancer: a structured review of the literature. Support Care Cancer. 2018;26(8):2511-8. http://dx.doi.org/10.1007/s00520-018-4227-9 PMid:29725802.
27. Zenga J, Goldsmith T, Bunting G, Deschler DG. State of the art: rehabilitation of speech and swallowing after total laryngectomy. Oral Oncol. 2018;86:38-47. http://dx.doi.org/10.1016/j.oraloncology.2018.08.023. PMid:30409318.
28. Terlingen LT, Pilz W, Kuijer M, Kremer B, Baijens LW. Diagnosis and treatment of oropharyngeal dysphagia after total laryngectomy with or without pharyngoesophageal reconstruction: systematic review. Head Neck. 2018;40(12):2733-48. http://dx.doi.org/10.1002/hed.25508. PMid:30478930.
29. Chawla S, Carney AS. Organ preservation surgery for laryngeal cancer. Head Neck Oncol. 2009;1(1):12. http://dx.doi.org/10.1186/1758-3284-1-12. PMid:19442314.
30. Lips M, Speyer R, Zumach A, Kross KW, Kremer B. Supracricoid laryngectomy and dysphagia: a systematic literature review. Laryngoscope. 2015;125(9):2143-56. http://dx.doi.org/10.1002/lary.25341. PMid:26013745.
31. Coca-Pelaz A, Rodrigo JP, Takes RP, Silver CE, Paccagnella D, Rinaldo A, Hinni ML, Ferlito A. Relationship between reflux and laryngeal cancer. Head Neck. 2013;35(12):1814-8. http://dx.doi.org/10.1002/hed.23208. PMid:23794281.
32. Zhang D, Zhou J, Chen B, Zhou L, Tao L. Gastroesophageal reflux and carcinoma of larynx or pharynx: a meta-analysis. Acta Otolaryngol. 2014;134(10):982-9. http://dx.doi.org/10.3109/00016489.2014.927592. PMid:25131391.
33. Dedivitis RA, Aires FT, Cernea CR, Brandão LG. Pharyngocutaneous fistula after total laryngectomy: systematic review of risk factors. Head Neck. 2015;37(11):1691-7. http://dx.doi.org/10.1002/hed.23804. PMid:24958209.
34. Jiang N, Zhang LJ, Li LY, Zhao Y, Eisele DW. Risk factors for late dysphagia after (chemo)radiotherapy for head and neck cancer: A systematic methodological review. Head Neck. 2016;38(5):792-800. http://dx.doi.org/10.1002/hed.23963. PMid:25532723.
35. Takes RP, Strojan P, Silver CE, Bradley PJ, Haigentz M Jr, Wolf GT, Shaha AR, Hartl DM, Olofsson J, Langendijk JA, Rinaldo A, Ferlito A. Current trends in initial management of hypopharyngeal cancer: the declining use of open surgery. Head Neck. 2012;34(2):270-81. http://dx.doi.org/10.1002/hed.21613. PMid:22228621. Rodrigues et al. Arch Head Neck Surg. 2023;52:e20230009.
36. Chung EJ, Jeong WJ, Jung YH, Kwon SK, Kwon TK, Ahn SH, Sung MW, Keam B, Heo DS, Kim JH, Wu HG, Lee KW, Eom KY, Rho YS. Long-term oncological and functional outcomes of induction chemotherapy followed by (chemo)radiotherapy vs definitive chemoradiotherapy vs surgery-based therapy in locally advanced stage III/IV hypopharyngeal cancer: Multicenter review of 266 cases. Oral Oncol. 2019;89:84-94. http://dx.doi.org/10.1016/j.oraloncology.2018.12.015. PMid:30732965.
37. Lai KWK, Lai R, Lorincz BB, Wang CC, Chan JYK, Yeung DCM. Oncological and functional outcomes of transoral robotic surgery and endoscopic laryngopharyngeal surgery for hypopharyngeal cancer: a systematic review. Front Surg. 2022;8:810581. http://dx.doi.org/10.3389/fsurg.2021.810581. PMid:35464886.
38. Sorensen JR, Bonnema SJ, Godballe C, Hegedüs L. The impact of goiter and thyroid surgery on goiter related esophageal dysfunction. a systematic review. Front Endocrinol. 2018;9:679. http://dx.doi.org/10.3389/fendo.2018.00679. PMid:30524374.
39. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133. http:// dx.doi.org/10.1089/thy.2015.0020 PMid:26462967.
40. Galluzzi F, Garavello W. Dysphagia following uncomplicated thyroidectomy: a systematic review. Eur Arch Otorhinolaryngol. 2019;276(10):2661-71. http:// dx.doi.org/10.1007/s00405-019-05599-y PMid:31414222.
41. Minuto MN, Reina S, Monti E, Ansaldo GL, Varaldo E. Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients. J Endocrinol Invest. 2019;42(11):1291-7. http://dx.doi.org/10.1007/s40618-019-01064-z. PMid:31124043.
42. Vardaxi C, Tsetsos N, Koliastasi A, Poutoglidis A, Sapalidis K, Triaridis S, Printza A. Swallowing disorders after thyroidectomy: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2022;279(9):4213-27. http://dx.doi.org/10.1007/ s00405-022-07386-8 PMid:35438344.
43. Heijnen BJ, Speyer R, Kertscher B, Cordier R, Koetsenruijter KW, Swan K, Bogaardt H. Dysphagia, speech, voice, and trismus following radiotherapy and/or chemotherapy in patients with head and neck carcinoma: review of the literature. BioMed Res Int. 2016;2016:6086894. http://dx.doi.org/10.1155/2016/6086894. PMid:27722170.
44. Porto de Toledo I, Pantoja LLQ, Luchesi KF, Assad DX, De Luca Canto G, Guerra ENS. Deglutition disorders as a consequence of head and neck cancer therapies: a systematic review and meta-analysis. Support Care Cancer. 2019;27(10):3681-700. http://dx.doi.org/10.1007/s00520-019-04920-z PMid:31230120. Rodrigues et al. Arch Head Neck Surg. 2023;52:e20230009.
45. Cousins N, MacAulay F, Lang H, MacGillivray S, Wells M. A systematic review of interventions for eating and drinking problems following treatment for head and neck cancer suggests a need to look beyond swallowing and trismus. Oral Oncol. 2013;49(5):387-400. http://dx.doi.org/10.1016/j.oraloncology.2012.12.002. PMid:23291294.
46. Kraaijenga SA, van der Molen L, van den Brekel MW, Hilgers FJ. Current assessment and treatment strategies of dysphagia in head and neck cancer patients: a systematic review of the 2012/13 literature. Curr Opin Support Palliat Care. 2014;8(2):152-63. http://dx.doi.org/10.1097/SPC.0000000000000050. PMid:24743298.
47. Hutchison AR, Cartmill B, Wall LR, Ward EC. Dysphagia optimized radiotherapy to reduce swallowing dysfunction severity in patients undergoing treatment for head and neck cancer: a systematized scoping review. Head Neck. 2019;41(6):2024-33. http://dx.doi.org/10.1002/hed.25688. PMid:30723986.
48. Duprez F, Madani I, De Potter B, Boterberg T, De Neve W. Systematic review of dose–volume correlates for structures related to late swallowing disturbances after radiotherapy for head and neck cancer. Dysphagia. 2013;28(3):337-49. http://dx.doi.org/10.1007/s00455-013-9452-2. PMid:23429941.
49. Skoretz SA, Anger N, Wellman L, Takai O, Empey A. A systematic review of tracheostomy modifications and swallowing in adults. Dysphagia. 2020;35(6):935-47. http://dx.doi.org/10.1007/s00455-020-10115-0. PMid:32377977.
50. Reddy PD, Yan F, Nguyen SA, Nathan CO. Factors influencing the development of pneumonia in patients with head and neck cancer: a metaanalysis. Otolaryngol Head Neck Surg. 2021;164(2):234-43. http://dx.doi. org/10.1177/0194599820938011. PMid:32660345.
Submitted date:
06/06/2023
Accepted date:
07/10/2023
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