Speech and swallowing rehabilitation of the patient with head and neck cancer
- Jan S Lewin, PhD
Jan S Lewin, PhD
- Professor, Department of Head and Neck Surgery
- Section Chief, Speech Pathology and Audiology
- The University of Texas MD Anderson Cancer Center
- Marita S Teng, MD, FACS
Marita S Teng, MD, FACS
- Associate Professor and Residency Program Director
- Department of Otolaryngology
- Head & Neck Surgery Icahn School of Medicine at Mount Sinai New York, NY
- Tamar Kotz, MS CCC-SLP
Tamar Kotz, MS CCC-SLP
- Head and Neck Speech Pathologist
- Otolaryngology-Head and Neck Surgery
- Icahn School of Medicine at Mount Sinai
- Section Editors
- Bruce E Brockstein, MD
Bruce E Brockstein, MD
- Section Editor — Cancer of the Head and Neck
- Clinical Professor of Medicine
- University of Chicago Pritzker School of Medicine
- Marvin P Fried, MD, FACS
Marvin P Fried, MD, FACS
- Section Editor — Head and Neck Surgery
- Professor and University Chairman, Department of Otorhinolaryngology - Head and Neck Surgery
- Montefiore Medical Center, Albert Einstein College of Medicine
Patients with head and neck cancer face multiple, often severe psychological and functional problems associated with the diagnosis and treatment of their disease. Rehabilitation and restoration of speech and swallowing are critical to optimize quality of life following treatment. (See "Health-related quality of life in head and neck cancer".)
Functional outcomes depend upon multiple factors, including the site of origin and stage of the cancer, treatment modality, extent of resection, type of reconstruction, and quality of rehabilitation. Anatomical preservation does not necessarily translate into preservation of organ function. Even treatments that permit organ preservation, surgical (eg, laser, robotic) or nonsurgical (eg, radiation therapy alone or in combination with chemotherapy), frequently result in severe functional sequelae . (See "Locally advanced squamous cell carcinoma of the head and neck: Approaches combining chemotherapy and radiation therapy".)
The critical components of speech and swallowing rehabilitation for the patient with head and neck cancer will be reviewed here. Alaryngeal speech restoration is discussed separately. (See "Alaryngeal speech rehabilitation".)
THE INTERDISCIPLINARY TEAM
Patients with head and neck cancer have a variety of speech and swallowing problems. Many factors contribute, including:
●Loss of anatomic structure and continuity within the upper aerodigestive tractTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- THE INTERDISCIPLINARY TEAM
- COMPLICATIONS AFTER RADIATION THERAPY
- Fibrosis and neuropathy
- Xerostomia and mucositis
- Gastrostomy tube placement
- - Primary tumor site
- - Treatment
- Other complications
- POSTSURGICAL COMPLICATIONS
- Minimally invasive techniques
- Oral cavity and oropharyngeal cancers
- - Treatment
- Laryngeal and hypopharyngeal cancers
- - Rehabilitation following laryngopharyngectomy
- - Rehabilitation following total laryngectomy