Formulating+your+therapy+Plan

It is important for the Speech and Language Pathologist to be aware of the general characteristics of dysphagia as a result of surgery and radiation therapy when planning formulating a therapy plan. When planning intervention the therapist can start by identifying the changes to the swallowing mecanism that are causing the swallowing problem. These changes changes are often caused by surgery and /or raqdiation therapy that can cause reduced movement of the structures involved in the swalowing mechanism. Patients who have a portion of the tongue removed exhibit worsened swallow function characterised by: The more of the tissue that is resected the worse the swallowing functions tends to be.
 * Prolonged oral preparatory time
 * slowed oral transit time
 * increased oral residue
 * increased pharyngeal residue

Radiation Therapy is often used postoperatively 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,2010). Radiotherapy can cause a wide variety of tissue and mucosal changes that can contibute to existing swallowing problems and even cause new problems. Potential side effects of radiation therapy that may contribute to dysphagia incllude: 
 * Mucositis
 * Xerostomia
 * <span style="color: black; display: block; line-height: normal; margin: 0cm 0cm 10pt; mso-list: l1 level1 lfo2; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list 36.0pt;"><span style="font-family: 'Arial','sans-serif'; font-size: 10pt;">Sensory changes in taste and smell
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