Pre- and Rehabilitation of Swallowing in Head and Neck Cancer Patients

Dysphagia is a common consequence of head and neck cancer (HNC) treatment, significantly impacting patients’ health and quality of life. Recent advances in prehabilitation and rehabilitation aim to preserve or improve swallowing function. This review critically evaluates the current evidence on direct swallowing exercises in HNC patients, focusing on their effectiveness, intervention parameters (content, dosage, timing, duration), and challenges related to adherence. Both prehabilitation and rehabilitation show potential to improve swallowing outcomes and enhance quality of life. However, the heterogeneity in definitions, intervention content, dosage, and timing limits comparability. High adherence is associated with improved outcomes but remains a significant challenge. Promising strategies for improving adherence include behavioural change techniques and focusing on known key facilitators and barriers. Despite increasing evidence for the efficacy of swallowing exercises in HNC care, the lack of standardization and methodological variation impedes guideline development. Future research should focus on achieving consensus on optimal protocols, improving adherence, and evaluating long-term outcomes, including cost-effectiveness.