Journal
CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS
Volume 11, Issue 2, Pages 93-104Publisher
SPRINGERNATURE
DOI: 10.1007/s40141-023-00388-5
Keywords
Late-RAD; Dysphagia; Survivorship; Radiation fibrosis syndrome; Head and neck cancer; Lower cranial nerve palsy
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Delayed onset of communication and swallowing dysfunction due to radiation-associated neuromuscular injury is a challenging clinical presentation in head and neck cancer rehabilitation. This review provides an evidence-based process for evaluating and treating this unique clinical entity. Rehabilitation interventions for radiation-fibrosis syndrome (RFS) include compensatory approaches, skill-based training, and restorative exercises, with ongoing research in this area.
Purpose of Review Delayed onset of communication and swallowing dysfunction due to radiation-associated neuromuscular injury is one of the most challenging clinical presentations in head and neck cancer rehabilitation. This review details the current literature and describes an evidence-based process for evaluating and treating this unique clinical entity. Recent Findings Radiation-fibrosis syndrome (RFS) is associated with lower cranial nerve palsy, dysphagia, trismus, dysarthria, dysphonia, and dyspnea. Sequelae of dysfunction can include feeding tube dependence, tracheostomy, depression, anxiety, and poor quality of life. While there is limited research evaluating rehabilitation efficacy explicitly in this population, the broader evidence base supports a multidimensional evaluation process and interventions that include compensatory approaches, skill-based training, and restorative exercises. Further evidence is forthcoming, with several ongoing randomized clinical trials exploring this topic. Summary Communication and swallowing dysfunction associated with RFS is debilitating, and treatment is intensive, often involving a phased approach with multiple specialties.
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