Functional Considerations

Abstract

This very important chapter focuses on the physiologic basis of the most fundamental functions of food intake, mastication, speech, and deglutition.

Disruption of these basic functions underlies almost all the morbidity that is encountered following treatment of head and neck cancers.

After a recapitulation of normal physiology, illustrated with some highly original schematic drawings to enunciate the phases of deglutition, this chapter discusses alterations that occur following disease and treatment, and the resulting impacts upon the patient. For example, it seeks to explain the phenomenon of micro-aspiration following chemoradiation for oropharyngeal primary cancers.

A clear understanding of these processes alone enables the surgeon to devise restorative strategies and the therapist to devise maneuvers to correct altered physiology and help address common morbidities associated with treatment.

This chapter also summarizes the most current efforts toward speech restoration and return of laryngeal protective function.