Challenges of Overcoming of Swallowing Difficulty Following Total Glossectomy, Laryngectomy and Resection of the Mandible

Abstract

Introduction The severity of swallowing difficulties after head and neck surgery depends on the range of excision as well as the patient’s age, concurrent chemoradiotherapy and other diseases. Swallowing difficulties resulting from structural changes in the oropharyngolaryngeal area require rehabilitation. In the normal swallowing process, bolus propulsion in the oral phase is facilitated primarily by the actions of the tongue 1), and contact with the posterior pharyngeal wall by the tongue base plays an important part in the pharyngeal stage of swallowing 2, 3). During swallowing, the base of the tongue and pharyngeal walls make complete contact 4)in order to propel the bolus though the pharynx. The movement of the posterior pharyngeal wall, including peristalsis-like waves, has been measured and investigated 5, 6). In this report, we aim to discuss the conditions of oral feeding in cases of total glossectomy, laryngectomy and subtotal mandibulectomy, emphasizing the importance of making complete contact by the reconstructed tongue base with the pharyngeal wall. The degree of contact affects the food consistency of the patient’s oral intake and quality of life. We also emphasize the need for swallowing rehabilitation in patients without a risk of aspiration.