Aspiration in head and neck surgical patients.

Aspiration, the entry of material into the airway below the true vocal folds, has been reported in various types of postsurgical head and neck patients. This study was designed to examine radiographically a group of 30 head and neck surgical patients with postoperative swallowing difficulties and to identify the relationship between the physiologic causes of aspiration in each patient and the surgical procedure. The modified barium swallow technique is needed to identify the nature of aspiration in these patients. Aspiration before, during, and after the swallow was caused by a variety of problems including reduced tongue control, delayed triggering of the swallowing reflex, reduced glottic closure, reduced laryngeal elevation, and reduced pharyngeal peristalsis. Eight patients exhibited two causes of aspiration. No one food consistency caused greater aspiration in all patients. The best and worst food consistencies varied with the cause of aspiration.