Surgery+and+Radiotherapy


 * Surgery and Radiotherapy **

Surgery to remove the cancer and/or effected areas and radiotherapy both increase rates of dysphagia in patients (Groher & Crary, 2010; Nguyen et al., 2008; Kendall, 1997).


 * Surgery **

(2;c) (A) T2 carcinoma of the right margin of the mobile tongue before laser microsurgery. (B) Results24 months following laser microsurgery

// Location of // Nyugen et al. and Pauloski et al. found that location of the tumor affected the severity of Dysphagia (2008; 2000 as cited in Nyugen et al, 2008). The location of the tumor will also affect the treatment options and how much of the tongue is able to be removed during surgery (Kronenberger & Meyers, 2004). Often during a glossectomy portions of the floor of the mouth will be removed due to the spread of cancerous cells (Kronenberger & Meyers, 1994).

// Aspiration // - Total glossectomy: removal of suprahyoid musculature (mylohyoid, geniohyoid) that is responsible for laryngeal support and elevation during swallowing = 10% to 37% aspiration found in these patients (Kronenberger & Meyers, 1994). - Partial glossectomy has lower rates of aspiration found in patients but this increases if the base of tongue is involved (Kronenberger & Meyers, 1994).

Specifics of what to look for during assessment are discussed more fully here

** Radiotherapy **

(2;d)

A plan for intervention should take into consideration the effects radiation treatment will have on the patient’s swallowing ability as well as more generally (Kendall, 1997). During the time of treatment patients often experience: · Mucositis (ulceration and inflammation of mucus membranes) causing pain · Swelling · Xerstomia (dry mouth) · Sensory changes (smell and taste) · Odynophagia (painful swallowing) · Loss of appetite · Infection · Firbrosis (excess tissue growth) · Neuropathy (nerve damage) · Changed anatomy ( eg. stricture/narrowing) · Infection · Dental changes (Kendall, 1997; Groher & Crary, 2010).

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