Late radiation-associated dysphagia with lower cranial neuropathy in long-term oropharyngeal cancer survivors: Video case reports

BackgroundLower cranial neuropathies are a late effect of radiotherapy (RT), typically reported in nasopharyngeal cancer survivors. Limited data examine these neuropathies after oropharyngeal cancer, particularly as it relates to late radiation-associated dysphagia (late-RAD). MethodsTwo cases were examined over 4 to 6 years. Late-RAD was assessed per MBS impairment profile (MBSImP (c)), Penetration-Aspiration Scale (PAS), Performance Status Scale for Head and Neck cancer (PSS-HN), and MD Anderson Dysphagia Inventory (MDADI). Neuropathies were examined via clinical examination and laryngeal videostroboscopy, and compared with trajectories of late-RAD. ResultsMedia-enriched case reports describe the course of late-RAD and neuropathies in 2 cases after definitive RTepidermal growth factor receptor-inhibitor for oropharyngeal cancer. Late-RAD was characterized by severe physiologic impairments per MBSImP (c) and decreased swallowing-related quality of life (QOL) per MDADI. Trajectories of late-RAD paralleled the progression or stability of neuropathies. ConclusionLate-RAD with lower cranial neuropathies resulted in profound and persistent functional impairment. Rarely reported, late radiation-associated lower cranial neuropathies may be a major contributor to new-onset or progressive dysphagia in long-term oropharyngeal cancer survivors. (c) 2014 Wiley Periodicals, Inc. Head Neck37: E56-E62, 2015