Jared Bradshaw, Jacqueline Tardif, David G Lott, Apoorva T Ramaswamy
Radiation-associated dysphagia (RAD) is a major short and long-term complication of treatment in head and neck cancer (HNC) patients associated with malnutrition, aspiration pneumonia, and markedly reduced quality of life. This review focuses exclusively on the management of RAD for the surgeon, emphasizing surgical techniques, functional rehabilitation, and emerging technologies. Post-operative dysphagia following surgical disease management (tumor resection, reconstruction, nerve injury) is an important but separate entity and is beyond the scope of this review. We discuss the pathophysiology of RAD, common clinical presentations, evidence-based surgical interventions, and future directions for study in optimizing post-radiotherapy swallowing function.