SUPER-SUPRAGLOTTIC SWALLOW IN IRRADIATED HEAD AND NECK-CANCER PATIENTS

Background. After radiotherapy to the head and neck, many patients exp erience swallowing difficulties. Preliminary work indicates that these patients benefit from the super-supraglottic swallow maneuver. Method s. Lateral videofluoroscopic studies examined oropharyngeal swallowing in 9 patients who suffered from dysphagia after radiation to the head and neck. Each patient completed two swallows each of 1 mt or 3 mt li quid barium without a voluntary swallow maneuver and with the super-su praglottic swallow designed to close the entrance to the airway early. The videotape of each swallow was digitized and the location of phary ngeal structures marked throughout the swallow. Movement over time plo ts were generated to measure changes in structural movement resulting from the maneuver. Results. The super-supraglottic swallow resulted in changes in airway entrance closure and hyolaryngeal movement. One pat ient who aspirated without the maneuver stopped aspirating with the ma neuver. Two others had aspiration reduced to a trace with the maneuver . Fewer swallow disorders were observed with the maneuver. Conclusion. The super-supraglottic swallow results in improved biomechanics of sw allow in irradiated head and neck cancer patients. (C) 1997 John Wiley & Sons, Inc.