, Volume 33, Issue 6, pp 739–748 | Cite as

Dysphagia and Oral Morbidities in Chemoradiation-Treated Head and Neck Cancer Patients

  • Yoshiaki Ihara
  • Michael A. CraryEmail author
  • Aarthi Madhavan
  • David C. Gregorio
  • Ikjae Im
  • Sarah E. Ross
  • Giselle D. Carnaby
Original Article


This study prospectively evaluated relationships between oral morbidities and swallowing ability in head/neck cancer patients following chemoradiation therapy (CRT) and at 3 months following CRT. Thirty patients with confirmed head/neck cancer undergoing chemoradiation were assessed with a battery of swallowing measures and measures of oral morbidities related to chemoradiation (xerostomia, mucositis, pain, taste/smell, oral moisture). All measures were completed at baseline (within the first week of CRT), at 6 weeks (end of treatment), and at 3 months following chemoradiation. Descriptive and univariate statistics were used to depict change over time in swallowing and each oral morbidity. Correlation analyses evaluated relationships between swallowing function and oral morbidities at each time point. Most measures demonstrated significant negative change at 6 weeks with incomplete recovery at 3 months. At 6 weeks, mucositis ratings, xerostomia, and retronasal smell intensity demonstrated significant inverse relationships with swallowing function. In addition, oral moisture levels demonstrated significant positive relationships with swallowing function. At 3 months, mucositis ratings maintained a significant, inverse relationship with swallow function. Taste and both orthonasal and retronasal smell intensity ratings demonstrated inverse relationships with measures of swallow function. Swallow functions and oral morbidities deteriorate significantly following CRT with incomplete recovery at 3 months post treatment. Furthermore, different patterns of relationships between swallow function measures and oral morbidities were obtained at the 6-week versus the 3-month assessment point suggesting that different mechanisms may contribute to the development versus the maintenance of dysphagia over the trajectory of treatment in these patients.


Dysphagia Head and neck cancer Oral morbidities Chemoradiation therapy 



This study was funded by a grant to Professor Crary from the Florida Department of Health—Bankhead-Coley Cancer Research Program (BB203). Dr. Yoshiaki Ihara’s participation on this project was supported by a Showa University Research Grant for Young Researchers.

Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local institutional review board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants including in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Swallowing Research Laboratory, Department of Communication Sciences and DisordersUniversity of Central FloridaOrlandoUSA
  2. 2.Division of Oral Rehabilitation Medicine, Department of Special Needs Dentistry, School of DentistryShowa UniversityTokyoJapan
  3. 3.Department of Communication Sciences and Disorders, College of Health and Human PerformanceThe Pennsylvania State UniversityUniversity ParkUSA
  4. 4.Graduate Program in Speech-Language TherapyChonbuk National UniversityJeonjuRepublic of Korea

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