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

Head Neck. 2020 May;42(5):898-904. doi: 10.1002/hed.26059. Epub 2019 Dec 27.

Abstract

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.

Keywords: dysphagia; feeding tube; neuropathy.

MeSH terms

  • Deglutition
  • Deglutition Disorders* / epidemiology
  • Deglutition Disorders* / etiology
  • Head and Neck Neoplasms* / complications
  • Humans
  • Larynx*
  • Prevalence
  • Retrospective Studies
  • Survivors