Predictability of oral and laryngopharyngeal function for aspiration and limitation of oral intake in patients after surgery for head and neck cancer.

Swallowing disorders are common in patients after surgery for head and neck cancer. The clinical assessment of oral and laryngopharyngeal abilities is widely used as a dysphagia assessment tool in this patient group, despite a lack of research. The goal of this study was to assess the predictability of clinical parameters for aspiration and limitation of oral intake. A swallowing disorder with the need for further intervention was identified by fiberoptic endoscopic evaluation of swallowing (FEES) in 65%, with aspiration in 49%, silently in 21%, and limited oral intake with tube dependency in 56% of studied patients. Four clinical parameters (dysglossia, wet voice, tongue motility, and tongue strength) correlated significantly with aspiration and limitation of oral intake. However, none of these clinical parameters was able to predict one of our two reference criteria, due to low positive likelihood ratios, mostly less than two. Clinical assessment is therefore inappropriate for early detection of swallowing disorders in such patients.