Short- and Long-Term Swallowing Outcomes in Head and Neck Cancer Patients Receiving TORS and Adjuvant Therapy

Background: Dysphagia (difficulty swallowing) is a common morbidity resulting from the treatment of head-and-neck squamous-cell carcinoma (HNSCC) due to surgery and chemoradiation. Transoral robotic surgery (TORS) is a minimally invasive surgical technique for the management of HNSCC, which ideally avoids many of the known complications of open surgery. Research describing physiologic swallowing impairment after surgery using videofluoroscopy is lacking. Methods: We evaluated videofluoroscopic swallowing studies of 37 patients who received TORS for head and neck cancer using a validated scoring tool, the Modified Barium Swallow Impairment Profile (MBSImP), at three time points including baseline. Results: Patients had worsened physiologic impairments in the immediate post-operative and late post-operative periods, particularly in components related to airway protection. Many patients also had baseline swallowing impairment. Conclusions: Further research is required to elucidate dysphagia at discrete time points before and after treatment as well as with different and evolving adjuvant therapy protocols.