Deglutição após tratamento não cirúrgico (radioterápico/ radioquimioterápico) do câncer de laringe

Radiation therapy and radiochemotherapy protocols can cause swallowing difficulties.Aim: To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors.Methods: A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing.Results: All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties.Conclusion: Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.FAP, Grad Course, Sao Paulo, BrazilUNIFESP EPM, Sao Paulo, BrazilUniv Sao Paulo, BR-09500900 Sao Paulo, BrazilHOSPHEL, Voice Rehabil & Swallowing Unit, Sao Paulo, BrazilFundacao Lusiada, Unilus, Santos, BrazilHOSPHEL, Inst Grad Vourse Hlth Sci, Sao Paulo, BrazilUNIFESP EPM, Sao Paulo, BrazilWeb of Scienc