Pretreatment swallowing function in patients with head and neck cancer

Background. Few objective data characterizing the pretreatment swallow func tion of patients with head and neck cancer are available. Methods. Pretreatment swallowing function in 352 patients with various lesi ons was evaluated with videofluoroscopy and compared with control subjects. Results. Patients had significantly longer oral and pharyngeal transit time s, greater amounts of oral and pharyngeal residue, shorter cricopharyngeal opening durations, and lower swallow efficiencies. Swallow function worsene d significantly with increased tumor stage, and patients with oral or phary ngeal lesions had worse swallow function than patients with laryngeal lesio ns. Frequency of complaint of swallow difficulty before treatment was 59%. Patients with lower stage tumors had fewer complaints of swallowing, as did patients with oral cavity lesions. Conclusions. Despite demonstrating significant differences from control sub jects, patients had highly functional swallows before treatment. The tenden cy for patients not to perceive a swallowing problem is consistent with the highly functional nature of their pretreatment swallow. (C) 2000 John Wile y & Sons. Inc.