Dysphagia: Head & Neck Cancer, Esophageal & Iatrogenic Disorders

Vocabulary flashcards covering major terms, procedures, disorders, treatments, and side effects related to dysphagia, head & neck cancer, esophageal and iatrogenic disorders presented in the lecture notes.

Cancer

Uncontrolled cell growth producing abnormal tissue; second leading cause of death in the U.S.

Head & Neck Cancer

Malignancies occurring in oral cavity, pharynx, larynx, etc.; ~3 % of U.S. cancers.

Primary Risk Factors (Head & Neck CA)

Smoking, heavy alcohol use, poor oral hygiene, mechanical irritation, HPV infection.

Metastasis

Spread of cancer cells to distant sites via blood or lymphatic system.

Tumor

Abnormal tissue growth; can be benign or malignant.

Benign Tumor

Non-cancerous mass that grows locally without invasion.

Malignant Tumor

Cancerous mass that invades nearby tissue and can spread.

General Warning Signs of Cancer

Unexplained weight loss, fever, fatigue, pain.

Specific Warning Signs of Cancer

Bowel/bladder change, non-healing sores, unusual bleeding, thickening or lump, dysphagia, etc.

White or Red Oral Sore

Persistent lesion in mouth; key head & neck cancer warning sign.

TNM System

Staging method: T=Tumor size, N=Node involvement, M=Metastasis.

T1 (Oropharyngeal)

Primary tumor ≤ 2 cm in greatest dimension.

T4 (Oropharyngeal)

Tumor invades adjacent structures.

N2c

Bilateral or contralateral lymph node metastasis, none > 6 cm.

M1

Presence of distant metastasis.

Stage 0 (Oropharyngeal)

Tis, N0, M0 – carcinoma in situ.

Stage IVB

Any T, N3, M0 – advanced regional disease.

Surgery (Cancer)

Physical removal of tumor and margin; may include lymph node dissection.

Resection

Surgical reconstruction to fill tissue removed with cancer.

Tracheotomy

Surgically created airway through neck into trachea.

Gastrostomy

Artificial external opening into stomach for nutrition (e.g., PEG).

Radiation Therapy

High-energy x-rays destroy cancer cells; external beam or internal implants.

External Beam Radiation

Radiation delivered from outside body directed at tumor.

Internal Radiation (Brachytherapy)

Radioactive pellets/rods placed in or near tumor site.

Chemotherapy

Systemic drugs used to kill or inhibit cancer cells.

Xerostomia

Persistent dry mouth due to salivary gland damage (common after radiation).

Odynophagia

Painful swallowing, often from mucosal irritation or radiation.

Fibrosis

Scar-like tissue formation causing reduced movement post-radiation.

Peripheral Neuropathy

Nerve damage causing sensation or motor deficits; radiation side effect.

Partial Glossectomy

Removal of < 50 % of tongue; can raise oral transit time.

Total Glossectomy

Removal of > 50 % of tongue; serious bolus propulsion problems.

Palatal Resection

Removal of > 50 % soft palate; may cause nasal regurgitation.

Hemi-laryngectomy

Unilateral partial laryngeal removal; reduces airway protection.

Supraglottic Laryngectomy

Removal above glottis; risks penetration/aspiration.

Total Laryngectomy

Entire larynx removed; airway separated via neck stoma.

Pharyngoesophageal (PE) Segment

Region at junction of pharynx and esophagus; critical for swallow.

Vallecular Residue

Bolus material remaining in valleculae post-swallow, often after tongue base surgery.

Dysphagia

Difficulty in swallowing affecting oral, pharyngeal, or esophageal phases.

Esophagus

Collapsed muscular tube (~23–25 cm) transporting bolus to stomach.

Upper Esophageal Sphincter (UES)

Muscular valve at top of esophagus controlling entry.

Lower Esophageal Sphincter (LES)

Muscle at distal esophagus preventing gastric backflow.

Esophageal Stenosis

Narrowing of esophagus leading to solid-food dysphagia.

Benign Stricture

Non-cancerous esophageal narrowing, commonly reflux-induced.

Malignant Stricture

Cancerous narrowing of esophagus.

Esophageal Diverticulum

Pouch protruding from esophageal wall; can trap food.

Zenker’s Diverticulum

Diverticulum at pharyngoesophageal junction; causes regurgitation.

Diffuse Esophageal Spasm

Uncoordinated esophageal contractions causing chest pain/dysphagia.

Nutcracker Esophagus

Excessively strong peristaltic contractions producing pain.

Achalasia

LES fails to relax; dysphagia to solids and liquids.

Myotomy

Surgical cutting of LES muscle to treat achalasia.

Gastroesophageal Reflux (GER)

Retrograde flow of gastric contents into esophagus.

Gastroesophageal Reflux Disease (GERD)

Symptomatic, chronic GER causing heartburn, dysphagia, etc.

Heartburn

Burning chest sensation due to acid reflux.

Proton Pump Inhibitors (PPIs)

Medications that lower gastric acid secretion for GERD.

Hiatal Hernia Repair

Surgical correction of stomach protrusion through diaphragm.

Laryngopharyngeal Reflux (LPR)

Gastric contents reach pharynx/larynx causing hoarseness, cough.

Globus Sensation

Feeling of something stuck in throat; common with reflux.

Cricopharyngeal Bar

Prominent cricopharyngeal muscle ridge on imaging; often incidental.

Iatrogenic Disorder

Condition inadvertently caused by medical treatment or procedure.

Post-Intubation Dysphagia

Swallowing difficulty following prolonged endotracheal intubation.

Thyroidectomy

Surgical removal of thyroid gland; may injure CN X leading to dysphagia.

Carotid Endarterectomy

Removal of carotid artery plaque; can temporarily impair swallow.

Esophagectomy

Removal of esophagus with reconstruction; disrupts motility.

Cervical Spine Fusion

Anterior surgical stabilization of cervical vertebrae; can injure CN IX–X.

Osteophytes

Bony outgrowths on vertebrae potentially compressing pharynx/esophagus.

Mucositis

Inflammation/ulceration of mucous membranes post-radiation/chemo.

Trismus

Fibrosis-related restricted jaw opening limiting oral intake.

Edema (Post-Surgery)

Swelling that restricts movement of swallowing structures.

Neuropathy (Radiation)

Nerve damage causing sensory/motor swallow deficits.

Xerostomia’s Swallow Impact

Reduces bolus lubrication, taste, and oral clearance.

Odynophagia’s Swallow Impact

Pain discourages eating, prolonging meal times.

PEG Tube

Percutaneous endoscopic gastrostomy for long-term enteral feeding.

Bolus Transit

Movement of food/liquid through oral-pharyngeal-esophageal tract.

Penetration

Entry of material into laryngeal vestibule above vocal folds.

Aspiration

Entry of material below vocal folds into airway.

Stricture (Neopharynx)

Narrowing of reconstructed pharyngeal channel post-laryngectomy.

Tracheoesophageal Fistula

Abnormal connection between trachea and esophagus.

Diffuse Dysphagia

Swallow difficulty affecting multiple consistencies and phases.

Odynophagia vs. Dysphagia

Painful swallowing vs. difficulty swallowing.

Peristalsis

Wave-like muscular contractions propelling bolus through esophagus.

Pharyngeal Residue

Material remaining in pharynx post-swallow, risk for aspiration.

Valleculae

Space between tongue base and epiglottis where residue can collect.

Pyriform Sinuses

Recesses beside laryngeal inlet prone to residue post-surgery.

Stoma

Permanent external opening for breathing after total laryngectomy.

Sensory Changes (Post-Radiation)

Altered taste/smell reducing appetite and swallow frequency.

Chemotherapy-Induced Nausea

Drug side effect causing vomiting, compromising nutrition.