Effectiveness of the Cough Reflex in Patients with Aspiration Following Radiation for Head and Neck Cancer

Lung. 2007 Sep-Oct;185(5):243-8. Epub 2007 Jul 28.
Effectiveness of the cough reflex in patients with aspiration following radiation for head and neck cancer.
Nguyen NP, Moltz CC, Frank C, Millar C, Smith HJ, Dutta S, Nguyen PD, Nguyen LM, Lemanski C, Ludin A, Jo BH, Sallah S.
Department of Radiation Oncology, University of Arizona, 1501 N Campbell Avenue, P.O. Box 245081, Tucson, Arizona 85724, USA. NamPhong.Nguyen@yahoo.com
The effectiveness of the cough reflex in patients who aspirated following radiation for head and neck cancer was evaluated in 89 patients (49 chemoradiation, 33 postoperative radiation, and 7 radiation alone). All patients had modified barium swallow because of dysphagia. The cough reflex was graded as present and effective, ineffective, intermittently effective, or absent. All patients were cancer-free at the time of the swallowing study. The cough reflex was present and effective in 46 patients (52%), ineffective in 17 patients (19%), and absent in 26 patients (29%) on initial investigation. Among the 43 patients who had ineffective or absent cough reflex, their treatment was chemoradiation (26), postoperative radiation (13), and radiation alone (4). In 30 patients who had sequential modified barium swallow, the cough reflex was constantly effective, ineffective, or intermittently effective in 12 (40%), 13 (43%), and 5 (17%) patients, respectively. The cough reflex was frequently ineffective or absent in patients who aspirated following radiation for head and neck cancer. Cough may also be intermittently ineffective to protect the airways following radiation.

PMID: 17661135 [PubMed - indexed for MEDLINE]