Bolus effects on patient awareness of swallowing difficulty and swallow physiology after chemoradiation for head and neck cancer

Nicole M. Rogus-Pulia*, Margaret Pierce, Bharat B. Mittal, Steven G. Zecker, Jeri Logemann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background Patients treated for head and neck cancer frequently develop dysphagia. Bolus characteristics are altered during fluoroscopic swallowing studies to observe the impact on swallowing function. The purpose of this study was to determine bolus volume and consistency effects on oropharyngeal swallowing physiology and patient awareness of swallowing difficulty. Methods Twenty-one patients with head and neck cancer were assessed pre-chemoradiation and post-chemoradiation. The Modified Barium Swallow Study (MBSS) was utilized to examine swallow physiology. Each patient provided perceptual ratings of swallowing difficulty after each swallow of varying bolus types. Results Oral transit times were significantly longer with pudding boluses. There were trends for higher residue percentages as well as perceptual ratings for pudding and cookie boluses. One correlation between perceptual ratings and physiology was significant. Conclusion Patient awareness of swallowing difficulty and aspects of swallowing physiology vary with bolus consistency. Patient awareness does not correlate with observed changes in swallowing physiology.

Original languageEnglish (US)
Pages (from-to)1122-1129
Number of pages8
JournalHead and Neck
Volume37
Issue number8
DOIs
StatePublished - Aug 2015

Keywords

  • bolus
  • chemoradiation
  • consistency
  • dysphagia
  • head and neck cancer
  • perception
  • volume

ASJC Scopus subject areas

  • Otorhinolaryngology

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