Skip to main content
SpringerLink
Log in

Rehabilitation of Heavily Treated Head and Neck Cancer Patients

  • Chapter
  • First Online:
Head and Neck Cancer

  • 2532 Accesses

Abstract

Head and neck cancer treatment may comprise several sequential or concurrent modalities, such as surgical resection and adjuvant radiation therapy or chemotherapy and radiation concurrently, known as chemoradiation. As the tumor grows larger or becomes more invasive, the patient is more likely to receive multimodality treatment, a combination of surgery with adjuvant chemoradiation. Often multimodality treatment produces greater changes in functional ability than single modality treatment, even if the patient receives two or three single modality treatments over a period of 5 or even more than 10 years.Integrative relationships to better understand these curatively aimed interventions in terms of their cross-system interactions and how they can impact clinical, particularly functional, and quality of life outcomes related to the upper airway are emerging very slowly for patients undergoing the treatments. That is likely because the training of scientists focusing on basic biological research traditionally has been vastly different from the research training offered to those interested in and/or providing clinical care, including rehabilitation. Various traditional interventions believed for decades to be safe are now questioned as risk factors for more disastrous consequences (e.g., feeding tube placement for enteral nutrition associated with increased risk of reflux and pneumonia in the elderly). Such problems emphasize the critical need for translation of new knowledge into patient-oriented research to address the underpinnings leading to diminished functioning in the upper aerodigestive tract. Elucidation of the underlying processes may facilitate treatments that minimize negative effects on function or that clarify better methods for rehabilitation. This chapter provides specific information, including different types of treatment and ­location, in the heavily treated head/neck cancer patient, with initial focus on surgery followed by radiation and chemotherapy. Discussion of specific functions integral to survival and quality of life accompany each section with emphasis on rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Kays S, Hind J, Gangnon R, Robbins J. Effects of dining on tongue endurance and swallowing-related outcomes. J Speech Lang Hear Res. 2010;53(4):898–907.

    Article  PubMed  Google Scholar 

  2. Nicosia MA, Hind JA, Roecker EB, Carnes M, Robbins JA. Age effects on the temporal evolution of isometric and swallowing pressure. J Gerontol A Biol Sci Med Sci. 2000;55A:M634–40.

    Google Scholar 

  3. Robbins J, Gangnon R, Theis S, Kays SA, Hind J. The effects of lingual exercise on swallowing in older adults. J Am Geriatr Soc. 2005;53:1483–9.

    Article  PubMed  Google Scholar 

  4. Tracy F, Logemann JA, Kahrilas PJ, Jacob P, Kobara M, Krugla C. Preliminary observations on the effects of age on oropharyngeal deglutition. Dysphagia. 1989;4:90–4.

    Article  PubMed  CAS  Google Scholar 

  5. El Sharkawi A, Ramig L, Logemann JA, et al. Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry. 2002;72:31–6.

    Article  PubMed  CAS  Google Scholar 

  6. Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001;344:665–71.

    Article  PubMed  CAS  Google Scholar 

  7. Johnston SD, Tham TC, Mason M. Death after PEG: results of the National Confidential Enquiry into Patient Outcome and Death. Gastrointest Endosc. 2008;68:223–7.

    Article  PubMed  Google Scholar 

  8. Hartig G, Chaiet G. Improving form and function through surgical care in head and neck squamous cell carcinoma. In: Harari P, Connor NP, Grau C, editors. Functional preservation and quality of life in head and neck radiotherapy. Berlin: Springer; 2009.

    Google Scholar 

  9. Amin MR, Koufman JA. Hemicricoidectomy for voice rehabilitation following hemilaryngectomy with ipsilateral arytenoid removal. Ann Otol Rhinol Laryngol. 2001;110:514–8.

    PubMed  CAS  Google Scholar 

  10. Som M. Surgery in premalignant lesions. Can J Otolaryngol. 1975;3:551.

    Google Scholar 

  11. Som ML, Silver CE. The anterior commissure technique of partial laryngectomy. Arch Otolaryngol. 1968;87:138–45.

    PubMed  CAS  Google Scholar 

  12. Jenkins P, Logemann J, Lazarus C, Ossoff R. Functional changes after hemilaryngectomy. Paper presented at the American Speech Language Hearing Association annual meeting. Los Angeles, CA; 1981.

    Google Scholar 

  13. Logemann J, Kahrilas P, Kobara M, et al. The benefit of head rotation on phayngoesophageal dysphagia. Arch Phys Med Rehabil. 1989;70:767–71.

    PubMed  CAS  Google Scholar 

  14. Welch MV, Logemann JA, Rademaker AW, Kahrilas PJ. Changes in pharyngeal dimensions effected by chin tuck. Arch Phys Med Rehabil. 1993;74:178–81.

    PubMed  CAS  Google Scholar 

  15. Hirano M. Technique for glottic reconstruction following vertical partial laryngectomy: a preliminary report. Ann Otol Rhinol Laryngol. 1976;85:25–31.

    PubMed  CAS  Google Scholar 

  16. Sasaki CT, Leder SB, Acton LM, Maune S. Comparison of the glottic closure reflex in traditional “open” versus endoscopic laser supraglottic laryngectomy. Ann Otol Rhinol Laryngol. 2006;115:93–6.

    PubMed  Google Scholar 

  17. McConnel FM, Mendelsohn MS, Logemann JA. Manofluorography of deglutition after supraglottic laryngectomy. Head Neck Surg. 1987;9:142–50.

    Article  PubMed  CAS  Google Scholar 

  18. Flores TC, Wood BG, Levine HL, Koegel Jr L, Tucker HM. Factors in successful deglutition following supraglottic laryngeal surgery. Ann Otol Rhinol Laryngol. 1982;91:579–83.

    PubMed  CAS  Google Scholar 

  19. Litton WB, Leonard JR. Aspiration after partial laryngectomy: cineradiographic studies. Laryngoscope. 1969;79:887–908.

    Article  PubMed  CAS  Google Scholar 

  20. Logemann J. Evaluation and treatment of swallowing disorders. 2nd ed. Austin, TX: Pro-Ed Inc.; 1998.

    Google Scholar 

  21. Staple TW, Ogura JH. Cineradiography of the swallowing mechanism following supraglottic subtotal laryngectomy. Radiology. 1966;87:226–30.

    PubMed  CAS  Google Scholar 

  22. Bernal-Sprekelsen M, Vilaseca-Gonzalez I, Blanch-Alejandro JL. Predictive values for aspiration after endoscopic laser resections of malignant tumors of the hypopharynx and larynx. Head Neck. 2004;26:103–10.

    Article  PubMed  Google Scholar 

  23. Ohmae Y, Logemann JA, Kaiser P, Hanson DG, Kahrilas PJ. Effects of two breath-holding maneuvers on oropharyngeal swallow. Ann Otol Rhinol Laryngol. 1996;105:123–31.

    PubMed  CAS  Google Scholar 

  24. Martin BJ, Schleicher MA, O’Connor A. Management of dysphagia following supraglottic laryngectomy. Clin Commun Disord. 1993;3:27–36.

    PubMed  CAS  Google Scholar 

  25. Logemann JA, Gibbons P, Rademaker AW, et al. Mechanisms of recovery of swallow after supraglottic laryngectomy. J Speech Hear Res. 1994;37:965–74.

    PubMed  CAS  Google Scholar 

  26. Veis S, Logemann JA, Colangelo L. Effects of three techniques on maximum posterior movement of the tongue base. Dysphagia. 2000;15:142–5.

    PubMed  CAS  Google Scholar 

  27. Shaker R, Kern M, Bardan E, et al. Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol. 1997;272:G1518–22.

    PubMed  CAS  Google Scholar 

  28. Jacob P, Kahrilas PJ, Logemann JA, Shah V, Ha T. Upper esophageal sphincter opening and modulation during swallowing. Gastroenterology. 1989;97:1469–78.

    PubMed  CAS  Google Scholar 

  29. Kahrilas PJ, Logemann JA, Krugler C, Flanagan E. Volitional augmentation of upper esophageal sphincter opening during swallowing. Am J Physiol. 1991;260:G450–6.

    PubMed  CAS  Google Scholar 

  30. Roh JL, Kim DH, Park CI. Voice, swallowing and quality of life in patients after transoral laser surgery for supraglottic carcinoma. J Surg Oncol. 2008;98:184–9.

    Article  PubMed  Google Scholar 

  31. Bron L, Brossard E, Monnier P, Pasche P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottic and supraglottic carcinomas. Laryngoscope. 2000;110:627–34.

    Article  PubMed  CAS  Google Scholar 

  32. Tucker HM. Conservation laryngeal surgery in the elderly patient. Laryngoscope. 1977;87:1995–9.

    Article  PubMed  CAS  Google Scholar 

  33. Lewin JS, Hutcheson KA, Barringer DA, et al. Functional analysis of swallowing outcomes after supracricoid partial laryngectomy. Head Neck. 2008;30:559–66.

    Article  PubMed  Google Scholar 

  34. Holsinger FC, Laccourreye O, Weinstein GS, Diaz Jr EM, McWhorter AJ. Technical refinements in the supracricoid partial laryngectomy to optimize functional outcomes. J Am Coll Surg. 2005;201:809–20.

    Article  PubMed  Google Scholar 

  35. Holsinger FC, Weinstein GS, Laccourreye O. Supracricoid partial laryngectomy: an organ-preservation surgery for laryngeal malignancy. Curr Probl Cancer. 2005;29:190–200.

    Article  PubMed  Google Scholar 

  36. Makeieff M, de la Breteque A, Guerrier B, Giovanni A. Voice handicap evaluation after supracricoid partial laryngectomy. Laryngoscope. 2009;119:746–50.

    Article  PubMed  Google Scholar 

  37. Myers EN, Suen JY. Cancer of the head and neck. 2nd ed. New York: Churchill Livingstone; 1989.

    Google Scholar 

  38. McConnel FM, Mendelsohn MS, Logemann JA. Examination of swallowing after total laryngectomy using manofluorography. Head Neck Surg. 1986;9:3–12.

    Article  PubMed  CAS  Google Scholar 

  39. Davis RK, Vincent ME, Shapshay SM, Strong MS. The anatomy and complications of “T” versus vertical closure of the hypopharynx after laryngectomy. Laryngoscope. 1982;92:16–22.

    PubMed  CAS  Google Scholar 

  40. Singer MI, Blom ED. Selective myotomy for voice restoration after total laryngectomy. Arch Otolaryngol. 1981;107:670–3.

    PubMed  CAS  Google Scholar 

  41. Case JL. Clinical management of voice disorders. 2nd ed. Austin, TX: Pro-Ed; 1991.

    Google Scholar 

  42. Diedrich WM, Youngstrom KA. Alaryngeal speech. Springfield, IL: Thomas; 1996.

    Google Scholar 

  43. McIvor J, Evans PF, Perry A, Cheesman AD. Radiological assessment of post laryngectomy speech. Clin Radiol. 1990;41:312–6.

    Article  PubMed  CAS  Google Scholar 

  44. Blom ED, Singer MI, Hamaker RC. A prospective study of tracheoesophageal speech. Arch Otolaryngol Head Neck Surg. 1986;112:440–7.

    PubMed  CAS  Google Scholar 

  45. Robbins J. Acoustic differentiation of laryngeal, esophageal, and tracheoesophageal speech. J Speech Hear Res. 1984;27:577–85.

    PubMed  CAS  Google Scholar 

  46. Robbins J, Fisher HB, Blom EC, Singer MI. A comparative acoustic study of normal, esophageal, and tracheoesophageal speech ­production. J Speech Hear Disord. 1984;49:202–10.

    PubMed  CAS  Google Scholar 

  47. Robbins J, Fisher HB, Blom ED, Singer MI. Selected acoustic ­features of tracheoesophageal, esophageal, and laryngeal speech. Arch Otolaryngol. 1984;110:670–2.

    PubMed  CAS  Google Scholar 

  48. Daniel RK, Taylor GI. Distant transfer of an island flap by microvascular anastomoses. A clinical technique. Plast Reconstr Surg. 1973;52:111–7.

    Article  PubMed  CAS  Google Scholar 

  49. Urken ML, Biller HF. A new bilobed design for the sensate radial forearm flap to preserve tongue mobility following significant glossectomy. Arch Otolaryngol Head Neck Surg. 1994;120:26–31.

    PubMed  CAS  Google Scholar 

  50. Skelly M. Glossectomee speech rehabilitation. Springfield, IL: Thomas; 1973.

    Google Scholar 

  51. McConnel FM, Logemann JA, Rademaker AW, et al. Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: a pilot study. Laryngoscope. 1994;104:87–90.

    PubMed  CAS  Google Scholar 

  52. Zimmerman J. Speech production after glossectomy. Paper presented at the American Speech Language Hearing Association annual meeting. New York; 1958.

    Google Scholar 

  53. Pauloski BR, Rademaker AW, Logemann JA, Colangelo LA. Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients. Otolaryngol Head Neck Surg. 1998;118:616–24.

    PubMed  CAS  Google Scholar 

  54. Robbins J, Kays SA, Gangnon R, Hewitt A, Hind J. The effects of lingual exercise in stroke patients with dysphagia. Arch Phys Med Rehabil. 2007;88:150–8.

    Article  PubMed  Google Scholar 

  55. Lazarus C, Logemann J, Huang C, Rademaker A. Effects of two types of tongue strengthening exercises in young normals. Folia Phoniatrica et Logopedica. 2003;55:199–205.

    Article  Google Scholar 

  56. Logemann J, Kahrilas P, Hurst P, Davis J, Krugler C. Effects of intraoral prosthetics on swallowing in oral cancer patients. Dysphagia. 1989;4:118–20.

    Article  PubMed  CAS  Google Scholar 

  57. Davis JW, Lazarus C, Logemann J, Hurst P. Effect of a maxillary glossectomy prosthesis on articulation and swallowing. J Prosthet Dent. 1987;57:715–9.

    Article  PubMed  CAS  Google Scholar 

  58. Sullivan P, Hind J, Roecker E, et al. Lingual pressure exercise protocol for head and neck cancer: a case study. Dysphagia. 2001;16:154 (Abst).

    Google Scholar 

  59. Pauloski BR, Logemann JA, Rademaker AW, et al. Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction. J Speech Hear Res. 1993;36:267–76.

    PubMed  CAS  Google Scholar 

  60. Cordeiro PG, Disa JJ, Hidalgo DA, Hu QY. Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg. 1999;104:1314–20.

    Article  PubMed  CAS  Google Scholar 

  61. Eisbruch A. Improving the quality of life of patients with head and neck cancer by highly conformal radiotherapy. In: Harari P, Connor NP, Grau C, editors. Functional preservation and quality of life in head and neck radiotherapy. Berlin: Springer; 2009.

    Google Scholar 

  62. Bourhis J, Amand C, Pignon J. Update of MACH-NC (meta-analysis of chemotherapy in head & neck cancer) database focused on concomitant chemoradiotherapy. J Clin Oncol. 2004;22:5505.

    Google Scholar 

  63. Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695–709.

    Article  PubMed  CAS  Google Scholar 

  64. Garcia-Peris P, Paron L, Velasco C, et al. Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: Impact on quality of life. Clin Nutr. 2007;26:710–7.

    Article  PubMed  CAS  Google Scholar 

  65. Rosenthal DI, Lewin JS, Eisbruch A. Prevention and treatment of dysphagia and aspiration after chemoradiation for head and neck cancer. J Clin Oncol. 2006;24:2636–43.

    Article  PubMed  Google Scholar 

  66. Trotti A, Bellm LA, Epstein JB, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol. 2003;66:253–62.

    Article  PubMed  Google Scholar 

  67. Ruo Redda MG, Allis S. Radiotherapy-induced taste impairment. Cancer Treat Rev. 2006;32:541–7.

    Article  PubMed  Google Scholar 

  68. Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB. Management of T1-T2 glottic carcinomas. Cancer. 2004;100:1786–92.

    Article  PubMed  Google Scholar 

  69. Carrara-de Angelis E, Feher O, Barros AP, Nishimoto IN, Kowalski LP. Voice and swallowing in patients enrolled in a larynx preservation trial. Arch Otolaryngol Head Neck Surg. 2003;129:733–8.

    Article  PubMed  Google Scholar 

  70. Lazarus CL. Management of swallowing disorders in head and neck cancer patients: optimal patterns of care. Semin Speech Lang. 2000;21:293–309.

    Article  PubMed  CAS  Google Scholar 

  71. Kotz T, Abraham S, Beitler JJ, Wadler S, Smith RV. Pharyngeal transport dysfunction consequent to an organ-sparing protocol. Arch Otolaryngol Head Neck Surg. 1999;125:410–3.

    PubMed  CAS  Google Scholar 

  72. Bleier BS, Levine MS, Mick R, et al. Dysphagia after chemoradiation: analysis by modified barium swallow. Ann Otol Rhinol Laryngol. 2007;116:837–41.

    PubMed  Google Scholar 

  73. Eisbruch A, Lyden T, Bradford CR, et al. Objective assessment of swallowing dysfunction and aspiration after radiation concurrent with chemotherapy for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2002;53:23–8.

    Article  PubMed  Google Scholar 

  74. Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008;30:148–58.

    Article  PubMed  Google Scholar 

  75. Chao KS, Deasy JO, Markman J, et al. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys. 2001;49:907–16.

    Article  PubMed  CAS  Google Scholar 

  76. Eisbruch A, Ship JA, Martel MK, et al. Parotid gland sparing in patients undergoing bilateral head and neck irradiation: techniques and early results. Int J Radiat Oncol Biol Phys. 1996;36:469–80.

    Article  PubMed  CAS  Google Scholar 

  77. Logemann JA, Pauloski BR, Rademaker AW, Colangelo LA. Speech and swallowing rehabilitation for head and neck cancer patients. Oncology (Williston Park). 1997;11:651–6. 659; discussion 659, 663–654.

    CAS  Google Scholar 

  78. Fujiu M, Logemann J. Effects of a tongue-holding manuever on posterior pharyngeal wall movement during deglutition. Am J Speech Lang Pathol. 1996;5:23–30.

    Google Scholar 

  79. Guadagnolo BA, Li S, Neuberg D, et al. Organ preservation and treatment toxicity with induction chemotherapy followed by radiation therapy or chemoradiation for advanced laryngeal cancer. Am J Clin Oncol. 2006;28:371–8.

    Article  Google Scholar 

  80. Abdel-Wahab M, Abitbol A, Lewin A, Troner M, Hamilton K, Markoe A. Quality-of-life assessment after hyperfractionated ­radiation therapy and 5-fluorouracil, cisplatin, and paclitaxel (Taxol) in ­inoperable and/or unresectable head and neck squamous cell ­carcinoma. Am J Clin Oncol. 2005;28:359–66.

    Article  PubMed  Google Scholar 

  81. Lawson JD, Otto K, Grist W, Johnstone PA. Frequency of esophageal stenosis after simultaneous modulated accelerated radiation therapy and chemotherapy for head and neck cancer. Am J Otolaryngol. 2008;29:13–9.

    Article  PubMed  Google Scholar 

  82. Mittal BB, Pauloski BR, Haraf DJ, et al. Swallowing dysfunction – preventative and rehabilitation strategies in patients with head-and-neck cancers treated with surgery, radiotherapy, and chemotherapy: a critical review. Int J Radiat Oncol Biol Phys. 2003;57:1219–30.

    Article  PubMed  Google Scholar 

  83. Thomas L, Jones TM, Tandon S, Carding P, Lowe D, Rogers S. Speech and voice outcomes in oropharyngeal cancer and evaluation of the University of Washington quality of life speech domain. Clin Otolaryngol. 2009;34:34–42.

    Article  PubMed  CAS  Google Scholar 

  84. van der Molen L, van Rossum MA, Burkhead LM, Smeele LE, Hilgers FJ. Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review. Eur Arch Otorhinolaryngol. 2009;266:901–2.

    Article  PubMed  Google Scholar 

  85. de Bruijn MJ, ten Bosch L, Kuik DJ, et al. Objective acoustic-phonetic speech analysis in patients treated for oral or oropharyngeal cancer. Folia Phoniatr Logop. 2009;61:180–7.

    Article  PubMed  Google Scholar 

  86. Jacobs LA, Palmer SC, Schwartz LA, et al. Adult cancer survivorship: evolution, research, and planning care. CA Cancer J Clin. 2009;59:391–410.

    Article  PubMed  Google Scholar 

  87. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. Washington, DC: National Academies Press; 2006.

    Google Scholar 

  88. Hoffman B, Stovall E. Survivorship perspectives and advocacy. J Clin Oncol. 2006;24:5154–9.

    Article  PubMed  Google Scholar 

  89. Carver JR, Shapiro CL, Ng A, et al. American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol. 2007;25:3991–4008.

    Article  PubMed  CAS  Google Scholar 

  90. Mao JJ, Bowman MA, Stricker CT, et al. Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol. 2009;27:933–8.

    Article  PubMed  Google Scholar 

  91. Harari PM, Connor NP, Grau C, (eds). Functional preservation and quality of life in head and neck radiotherapy. (Medical Radiology Series/Radiation Oncology) Berlin: Springer-Verlag; 2009.

    Article  PubMed  Google Scholar 

  92. Grunfeld E. Primary care physicians and oncologists are players on the same team. J Clin Oncol. 2008;26:2246–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

The authors wish to acknowledge Dr. Jerilyn Logemann’s major and ongoing contributions to the field of swallowing and speech rehabilitation for head and neck cancer patients. Without Dr. Logemann’s enduring focus, there would be little known and much less to offer our many heavily treated head and neck cancer patients we see in the clinic every day.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Wisconsin, Madison, WI, 53726, USA

    JoAnne Robbins

  2. Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA

    JoAnne Robbins

Authors
  1. Rachael E. Kammer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. JoAnne Robbins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to JoAnne Robbins .

Editor information

Editors and Affiliations

  1. , Dept of Radio-Oncology, Genolier Swiss Medical Network, 4 Route du Muids, Genolier, CH-1272, Switzerland

    Jacques Bernier

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Kammer, R.E., Robbins, J. (2011). Rehabilitation of Heavily Treated Head and Neck Cancer Patients. In: Bernier, J. (eds) Head and Neck Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9464-6_45

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-9464-6_45

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-9463-9

  • Online ISBN: 978-1-4419-9464-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation