--+Be+aware+of+Side+affects+after+surgery+and+radiation+when+planning+intervention

=Side effects of surgery and Radiation that influence intervention=

In order to provide the patient with the best tretment possible for any swallowing dificultuies a comprehensive and individualised assessment, ( as described in assessment section) must first be carried out to determine the presence and severity of the swallowing difficulties. It is important for the speech and language therapist to be aware of the general characteristics of dysphagia as a result of surgery and radiation therapy when plannig intervention. When planning your intervention the therapist can start by identifying the changes to the swallowing mechanism that are causing the swallowing problems, ( Byron et al, 2006).These changes are often caused by surgery and /or radiation therapy. Patients who have a potion of the oal tongue removed exhibit worsened swallowing function characterised by:
 * prolonged oral preparatory time
 * slowed oral transit time
 * increased oral residue
 * increased pharyngeal residue

Radiation therapy is often used post operatively to control for microscopic disease. Generally speaking swallowing problems after radiation therapy in isolation or in combination with surgery tend to be worse then those encountered after surgery alone, ( Crary ey al 2010).Radiation therapy can cause a wide variety of tissue and mucosal changes that can contribute to existing swallowing problems and even cause new problems. Potential seide efftects of radiation therapy that may contribute to dysphagia include: and smell ||
 * mucositis || xerostomia || fibrosis || neuropathy || changed anatomy || odynophagia || edema || loss of appetite || edema || infection || dental changes || changes in taste