Evaluation of Role of Prophylactic Swallowing Rehabilitation in Chemoradiotherapy for Advanced Head and Neck Cancer Using Novel Software Analysis of Videofluorography Images

Concurrent chemoradiotherapy (CRT) for head and neck cancer (HNC) is associated with substantial side effects, most notably those related to swallowing function. Recently, early implementation of protective exercises has been recommended as an important intervention in patients treated with chemoradiotherapy. Several studies, including randomized controlled trials, have evaluated prophylactic swallowing exercises and swallowing outcomes. Although several clinical outcome measures to assess the severity of swallowing dysfunction are available, they are indirect measures. Videofluorography is the most popular and efficient examination that visually demonstrates the dynamic state of swallowing. This study aimed to determine whether prophylactic swallowing rehabilitation provided to HNC patients receiving CRT would result in better swallowing outcomes. Thirty patients were enrolled in this study. Fifteen patients (the control group) received swallowing rehabilitation after CRT on demand, and the other 15 (the rehabilitation group) received prophylactic swallowing rehabilitation from the beginning. Swallowing motion was evaluated with motion analysis software. There were statistically significant differences in hyoid bone displacement, duration of swallowing onset, larynx elevation time, and total swallowing time between the control and rehabilitation groups. Based on the results of this study, prophylactic swallowing rehabilitation seems to reduce the extent and severity of the functional problems that occur after CRT.