SWALLOWING OF BOLUS TYPES BY POSTSURGICAL HEAD AND NECK-CANCER PATIENTS

Background. Clinically, head and neck cancer patients with anterior re sections have better postoperative outcomes than do patients with post erior resections. Methods. Videofluoroscopy was used to study the swal lowing characteristics in postsurgery head and neck cancer patients an d normal controls. Most patients received postoperative radiotherapy a nd chemotherapy, and no cancer recurrence was noted at the time of stu dy, 4-8 months posttreatment. Bolus types included: 3 mL and 10 mL liq uid barium, barium paste, and barium-coated cookie. Temporal measureme nts and a count of the number of swallows required to ingest each mate rial were made from the videotaped data. Statistical analysis using an unbalanced univariate repeated measures ANOVA was performed. Results. The major differences were found between bolus types, with few differ ences noted between surgical groups (anterior vs posterior resections) and normal controls. Patients took longer to ingest viscous material, accomplishing this by multiple piecemeal and clearing swallows. Coord ination of mastication and swallowing of the cookie was different betw een normal and patient groups. Conclusions. Patients who are able to s wallow reasonably well postoperatively maintain normal coordination an d timing of swallowing activity and do not vary these parameters to co mpensate for structural inadequacy. Instead, repeated swallows are use d. (C) 1994 John Wiley & Sons, Inc.