Longitudinal assessment of swallowing function in laryngeal cancer patients undergoing radiotherapy or chemoradiotherapy: a fiber-optic endoscopic evaluation of swallowing (FEES)-based study

Abstract Background This study evaluated swallowing outcomes in laryngeal cancer patients following radiotherapy (RT) or chemoradiotherapy (CRT). Methods Swallowing function was evaluated in 60 laryngeal cancer patients treated with RT/CRT using fiber-optic endoscopic evaluation of swallowing (FEES) and Arabic Dysphagia Handicap Index (A-DHI) at pretreatment (baseline) and at 2- and 6-month post-treatment. Results Residue was observed in 80% of patients at baseline, increasing to 93.3% at both 2-month and 6-month posttreatment evaluations. At 6 months, there was a significant association between TNM staging and severity of residue ( P -value: 0.003) and between TNM and DHI score ( P -value: 0.001). Conclusion Dysphagia is a common complication of laryngeal cancer, often presented as residue, particularly with semisolid textures. Mild to moderate residue carries low aspiration risk. Residue severity and A-DHI scores worsened shortly after treatment but partially improved by the 6-month follow-up. A significant association was found between advanced TNM staging and greater residue severity at 6 months.