Prevalence of profound laryngeal sensory neuropathy in head and neck cancer survivors with feeding tube‐dependent oropharyngeal dysphagia

• Published in: Head & neck Vol. 42; no. 5; pp. 898 - 904
• Main Authors: Mehdizadeh, Omid B., Dhar, Shumon I., Evangelista, Lisa, Nativ‐Zeltzer, Nogah, Bewley, Arnaud F., Belafsky, Peter C.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-05-2020; Wiley Subscription Services, Inc
• Subjects: Cough; Cranial nerves; Dysphagia; Esophagus; feeding tube; Fibrosis; Head & neck cancer; Larynx; Nasopharynx; Neuropathy; Oral cavity; Oropharynx; Pharynx; Stenosis; Swallowing; Thyroid; dysphagia; feeding tube; neuropathy
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.26059

Background
Laryngopharyngeal sensory neuropathy (LSN) has been observed to be a contributing factor to swallowing dysfunction in head and neck cancer (HNC) survivors.
Methods
Retrospective review of 43 tube‐dependent HNC survivors was conducted. LSN was assessed with direct palpation of the aryepiglottic fold and by traversing the true vocal folds without eliciting a cough reflex with a flexible laryngoscope.
Results
The primary tumor sites were oropharynx (51%), larynx (14%), nasopharynx (4.7%), oral cavity (14%), thyroid (4.7%), unknown primary (9.3%), and esophagus (2.3%). The prevalence of profound LSN was 79.1%. Objective fluoroscopic parameters contributing to swallowing dysfunction were diminished laryngohyoid elevation (100%), pharyngeal weakness (67%), and reduced lateral PES opening (37%).
Conclusions
The prevalence of LSN in HNC survivors with feeding tube‐dependent dysphagia is high (79.1%). The data suggest that LSN, in addition to fibrosis, pharyngoesophageal stenosis, and cranial nerve motor deficits contributes to swallowing dysfunction in these patients.