Abstract
To establish a precise rehabilitation program for dysphagia after surgical procedure for head and neck cancer, it is very important to address not only body functions but also restrictions in participation and activity. A team approach (with nurses, speech language pathologists, nutritionists, psychiatrists and dentists) is necessary for intensive dysphagia intervention. Surgical plans (organs resected and reconstruction methods) can be a predictor of swallowing disturbance. We can devise a rehabilitative approach before surgery. Swallow exercise before surgery enables patients to understand how to prepare for the operation and provides a sense of ease. Swallow exercise is started just after wound healing, with basic (indirect) exercise followed by phased direct exercise. Based on accurate evaluation of videofluorography and fiberendoscopic evaluation of swallowing, we can select suitable rehabilitative approaches. In severe cases, surgery such as laryngeal suspension, cricopharyngeal myotomy and arytenoid adduction, needs to be considered in conjunction with continuous therapy.
