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. 2025 May;47(5):1345-1354.
doi: 10.1002/hed.28033. Epub 2024 Dec 23.

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

Affiliations

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

Abigail C Weiland et al. Head Neck. 2025 May.

Abstract

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.

Keywords: TORS; dysphagia; swallowing; videofluoroscopy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
17% improved, 35% remained the same, and 48% worsened. Of those who worsened 64% (7/11) progressed from no penetration/aspiration to penetration OR penetration to aspiration and 18% (2/11) progressed from no penetration/aspiration to aspiration. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
27% improved, 47% remained the same, and 27% worsened. Of those who worsened, 75% (3/4) progressed from no penetration/aspiration to penetration OR penetration to aspiration. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
0% improved, 63% remained the same, and 38% worsened. Of those patients who worsened, 50% (3/6) progressed from no penetration/aspiration to penetration OR penetration to aspiration. [Color figure can be viewed at wileyonlinelibrary.com]

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