2022 Volume 26 Issue 1 Pages 31-38
Treatment of head and neck cancer may often cause dysphagia. Dysphagia has been reported to affect a patient’s quality of life and nutritional status. Herein, we report three cases of postoperative dysphagia patients who received head and neck cancer treatment. These patients underwent hospitalized intensive dysphagia rehabilitation shortly after leaving the acute care hospital and had improved swallowing function.
Case 1: A 65-year-old man was diagnosed with dysphagia secondary to treatment of a left-sided oral floor cancer. He had difficulties in transferring bolus into the pharynx. He was instructed to perform direct training along with changes in body posture that included leaning on his right side and rotating his head to the left side three times a day, with indirect training and coughing in the forward inclined posture. His Fujishima’s Grade improved from 3 to 8 and his Fujishima’s Level improved from 3 to 8 within 9 days of hospitalization.
Case 2: A 59-year-old man was diagnosed with dysphagia after undergoing treatment of a cancer on the left side of his oropharynx. He presented with difficulties in transferring bolus into the pharynx and upper esophageal sphincter dysfunction. He was instructed to perform direct training with changes in body posture that included leaning on the right side and rotating his head to the left side three times a day along with indirect training using the balloon dilatation method and coughing in a forward inclined posture. His Fujishima’s Grade improved from 2 to 5 and his Fujishima’s Level improved from 1 to 5 within 4 days of hospitalization.
Case 3: A 32-year-old man was diagnosed with dysphagia after undergoing treatment of a cancer on the left side of his tongue; subsequently, he had difficulties in transferring bolus into the pharynx. He was instructed to perform direct training while in a lying-down posture three times a day along with indirect training and coughing in a forward inclined posture. He also performed cervical and shoulder stretching, and tongue strengthening exercises. His Fujishima’s Grade improved from 5 to 8 and His Fujishima's Level improved from 4 to 7 within 8 days of hospitalization.
Discussion: Swallowing function improved in these three cases after they underwent hospitalized intensive dysphagia rehabilitation. These patients were instructed to perform both direct training (postural control techniques) and indirect training (coughing in the forward inclined posture). This suggests that swallowing function might be improved more effectively by suitable intensive training shortly after being discharged from the acute care hospital.