Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

Figure 1

Lateral fluoroscopic view of a 49-year-old man who has undergone a near-total glossectomy for advanced head and neck cancer. A small amount of tongue is seen. The patient has poor oral bolus control and early loss into the oropharynx ((a) white arrows). He has lost his ability to pull the hyoid and the larynx up and forward to open the upper esophageal sphincter resulting in pharyngeal dysphagia and food remaining in pharynx (white arrows) with penetration just over arytenoid complex, remaining above the vocal folds (black arrows). This represents a penetration and aspiration score of 3 (b).

(a)

(b)