Asunto(s)
Bruxismo , Trastornos de Deglución , Clorhidrato de Duloxetina , Discinesia Tardía , Humanos , Clorhidrato de Duloxetina/efectos adversos , Discinesia Tardía/inducido químicamente , Trastornos de Deglución/inducido químicamente , Bruxismo/inducido químicamente , Anciano de 80 o más Años , Femenino , Masculino , Inhibidores de Captación de Serotonina y Norepinefrina/efectos adversosRESUMEN
Food aspiration is one of the major health risks for elderly people in nursing homes which could lead to death. Moreover, misconducts in pharmacotherapy may represent a potential risk of adverse drug reactions. It is reported here the toxicological evaluation of a combined death by food aspiration and acute escitalopram intoxication of a psychiatric subject, occurred in a nursing home. An 89-year-old man, suffering from dysphagia and Alzheimer's, was resident in a nursing home. He was fed with a liquid diet administered directly in mouth using a syringe. The man was also being treated with escitalopram 10 mg tablet. One evening, after receiving the meal in the usual way, the man complained of sudden illness. Carried to the emergency room, the man died about 3 h later with a diagnosis of cardiogenic shock subsequentially to ab ingestis. The histological findings revealed the presence of exogenous material, probably food, up to the finest bronchial branches. The toxicological examination revealed the presence of escitalopram and its main metabolite, desmethylcitalopram: in the blood 1972 ng/ml and 285 ng/ml, in the brain 4657 ng/g and 1025 ng/g, in the gastric content 2317 ng/g and 423 ng/g, in the lung 21,771 ng/g and 468 ng/g, respectively. The bad practice of the nurses to dissolve the escitalopram tablet in the liquefied food and to administer the therapy with a syringe directly into the mouth emerged thanks this investigation. Following food aspiration, escitalopram was absorbed by inhalation route, reaching high concentrations in blood and tissues. The death occurred due to a combined mechanism between food aspiration and the escitalopram toxic action.
Asunto(s)
Citalopram , Casas de Salud , Aspiración Respiratoria , Inhibidores Selectivos de la Recaptación de Serotonina , Humanos , Citalopram/análisis , Citalopram/envenenamiento , Citalopram/análogos & derivados , Masculino , Anciano de 80 o más Años , Inhibidores Selectivos de la Recaptación de Serotonina/envenenamiento , Inhibidores Selectivos de la Recaptación de Serotonina/análisis , Encéfalo/patología , Contenido Digestivo/química , Pulmón/patología , Trastornos de Deglución/inducido químicamente , Enfermedad de AlzheimerRESUMEN
INTRODUCTION: Pediatric prucalopride studies for treatment of gastrointestinal (GI) disorders have reported mixed results. We aimed to assess the safety and effectiveness of prucalopride in functional constipation (FC) with and without upper GI symptoms. METHODS: Retrospective data on patients with FC receiving combined prucalopride and conventional therapy was compared with those receiving conventional therapy alone within 12 months. Thirty patients on combined therapy and those on conventional therapy were each matched on the basis of age, gender, race, and presence of fecal soiling. Response (complete, partial, or no resolution) was compared. Similarly, response to concurrent functional upper GI symptoms (postprandial pain, bloating, weight loss, vomiting, early satiety, or nausea) and dysphagia, as well as adverse effects, were evaluated in the combined group. RESULTS: Mean age of 57 cases was 14.7 ± 4.9 years and 68% were female. Comorbidities included functional upper GI (UGI) symptoms (84%), dysphagia (12%), mood disorders (49%), and hypermobility spectrum disorder (37%). Unmatched cases reported 63% improvement to FC; response did not differ between the matched cohorts (70% versus 76.6%, p = 0.84). Cases showed a 56% improvement in functional UGI symptoms and 100% in dysphagia. Adverse effects were reported in 30%, abdominal cramps being most common. Four (7%) patients with a known mood disorder reported worsened mood, of which two endorsed suicidal ideation. CONCLUSION: Prucalopride efficaciously treated concurrent UGI symptoms and dysphagia in constipated pediatric patients and was overall well tolerated. Preexisting mood disorders seemed to worsen in a small subset of cases.
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Benzofuranos , Trastornos de Deglución , Humanos , Femenino , Niño , Persona de Mediana Edad , Masculino , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/tratamiento farmacológico , Estudios Retrospectivos , Estreñimiento/tratamiento farmacológico , Benzofuranos/efectos adversosRESUMEN
We evaluated the pathophysiology of dysphagia considered to be induced by benzodiazepine using high-resolution manometry (HRM). A 53-year-old man with Parkinson disease had had dysphagia for over 3 months. He had been taking several benzodiazepines for more than four years. Two weeks after discontinuation of the benzodiazepines, HRM revealed increased pharyngeal contractility and residual pressure at the upper esophageal sphincter. A video-fluoroscopic swallowing study showed improved pharyngeal bolus passage. Benzodiazepine-induced dysphagia may be due to the muscle relaxant effects on the swallowing muscles and attenuation of the barrier function which prevents reflux from the esophagus into the pharynx.
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Trastornos de Deglución , Masculino , Humanos , Persona de Mediana Edad , Trastornos de Deglución/inducido químicamente , Benzodiazepinas , Faringe/fisiología , Manometría , Deglución/fisiología , Esfínter Esofágico SuperiorRESUMEN
BACKGROUND: Sedative agents increase the risk of pulmonary aspiration, where an intact swallowing function is an important defense mechanism. Dexmedetomidine is an α2 -adrenoceptor agonist widely used during procedural sedation due to beneficial properties with minimal respiratory effects. The effects of dexmedetomidine on pharyngeal swallowing and esophageal motility are not known in detail. METHODS: To determine the effects of dexmedetomidine on pharyngeal swallowing and esophageal motility, nineteen volunteers were included in this double-blinded, randomized placebo-controlled cross-over study. Study participants received target-controlled dexmedetomidine and placebo infusions. Recordings of pressure and impedance data were acquired using a manometry and impedance solid-state catheter. Data were analyzed from three bolus swallows series: baseline, during dexmedetomidine/placebo infusion at target plasma concentrations 0.6 ng ml-1 and 1.2 ng ml-1 . Subjective swallowing difficulties were also recorded. KEY RESULTS: On pharyngeal swallowing, dexmedetomidine affected the upper esophageal sphincter with decreased pre- and post-swallow contractile pressures and an increase in residual pressure during swallow-related relaxation. On esophageal function, dexmedetomidine decreased contractile vigor of the proximal esophagus and increased velocity of the peristaltic contraction wave. Residual pressures during swallow-related esophagogastric junction (EGJ) relaxation decreased, as did basal EGJ resting pressure. The effects on the functional variables were not clearly dose-dependent, but mild subjective swallowing difficulties were more common at the higher dose level. CONCLUSIONS AND INFERENCES: Dexmedetomidine induces effects on pharyngeal swallowing and esophageal motility, which should be considered in clinical patient management and also when a sedative agent for procedural sedation or for manometric examination is to be chosen.
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Trastornos de Deglución , Dexmedetomidina , Humanos , Dexmedetomidina/farmacología , Estudios Cruzados , Deglución , Voluntarios Sanos , Esfínter Esofágico Superior , Trastornos de Deglución/inducido químicamente , Manometría , Hipnóticos y Sedantes/farmacología , FaringeRESUMEN
BACKGROUND: Dysphagia has been reported as an adverse event for patients receiving rivastigmine for Alzheimer's disease (AD) treatment. OBJECTIVE: The purpose of this study was to determine the association between dysphagia and the usage of rivastigmine by using the pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS). METHODS: The risk of dysphagia in patients who took rivastigmine was compared with those of patients who took other medications. In addition, this study sought to determine if the dysphagia risk was influenced by sex, age, dosage, and medication routes of administration. RESULTS: When compared to patients prescribed donepezil, galantamine, or memantine, individuals prescribed rivastigmine were almost twice as likely to report dysphagia as an adverse event. The dysphagia risk in individuals prescribed rivastigmine is comparable to individuals prescribed penicillamine but significantly higher than clozapine, drugs of which have been previously shown to be associated with elevated dysphagia likelihood. Individuals older than 80 were 122% more likely to report having dysphagia after being prescribed rivastigmine than patients that were 50-70 years of age. Oral administration of rivastigmine was associated with approximately 2 times greater likelihood of reporting dysphagia relative to users of the transdermal patch. In addition, dysphagia showed higher association with pneumonia than other commonly reported adverse events. CONCLUSION: Patients prescribed rivastigmine were at greater risk of reporting dysphagia as an adverse event than patients prescribed many other medicines. This increase in dysphagia occurrence may be attributed to the dual inhibition of both acetylcholinesterase and butyrylcholinesterase.
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Enfermedad de Alzheimer , Clozapina , Trastornos de Deglución , Acetilcolinesterasa , Enfermedad de Alzheimer/inducido químicamente , Enfermedad de Alzheimer/tratamiento farmacológico , Butirilcolinesterasa , Inhibidores de la Colinesterasa/efectos adversos , Clozapina/uso terapéutico , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/tratamiento farmacológico , Trastornos de Deglución/epidemiología , Donepezilo/uso terapéutico , Galantamina/uso terapéutico , Humanos , Memantina/uso terapéutico , Penicilamina/uso terapéutico , Gestión de Riesgos , Rivastigmina/efectos adversos , Estados Unidos , United States Food and Drug AdministrationRESUMEN
Recently, it was demonstrated that copper complexes and 3,4-diaminopyridine can effectively reduce the activity of the botulinum neurotoxin light chain. The aim of the present study was to indicate that treatment with an antidote may have a major influence, not only on the extremely rare disease of botulism, but also on the much more frequently occurring side effects experienced during BoNT therapy. This was a retrospective chart review of patients who were regularly treated with BoNT for various indications. The percentage of patients with clinical signs of overdosing was determined. In patients with facial dystonia, double vision and ptosis occurred as side effects. In patients with cervical dystonia, neck weakness and dysphagia were observed as the most frequent side effects. In oromandibular and oropharyngeal dystonia, abnormal tongue movements and dysphagia occurred frequently. In writer's cramp and mild post-stroke hand spasticity, severe paresis of the injected and non-injected finger muscles was observed. Additionally, in the BoNT treatment of pain syndromes (such as tension headaches or migraines), neck weakness may occur. Across all indications for clinical BoNT applications, clinical signs of BoNT overdosing may occur in up to 5% of the BoNT-treated patients. Therefore, the development of an antidote for BoNT overdoses would be very much appreciated and would have a major influence on the management of BoNT therapy.
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Toxinas Botulínicas Tipo A , Trastornos de Deglución , Distonía , Antídotos/uso terapéutico , Toxinas Botulínicas Tipo A/efectos adversos , Toxinas Botulínicas Tipo A/uso terapéutico , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/tratamiento farmacológico , Distonía/inducido químicamente , Distonía/tratamiento farmacológico , Humanos , Estudios RetrospectivosRESUMEN
Although the modified barium swallowing study (MBSS) is considered the gold standard for assessing aspiration risk, aspiration of lipid-soluble barium can cause chemical pneumonitis or impair radiologic interpretation of the lungs. Water-soluble contrast agents (WSCAs) may avoid these complications while maintaining sensitivity on aspiration. This prospective, observational, case-control cohort trial evaluated all patients >3 years old referred for swallowing study from September 2015 to November 2017. Repeat evaluations of individuals were excluded. High-risk patients were evaluated by WSCA (iohexol)-based swallowing study (WSS) and others by MBSS. The study included 829 evaluations of 762 patients. After excluding 74 evaluations, 365 WSSs and 390 MBSSs were performed. The most frequent underlying condition was brain lesion, followed by aspiration pneumonia. Aspiration occurred more frequently in WSS (147 patients: 40.3%) than in MBSS (36 patients: 9.2%) (P = .00). However, neither aspiration volume (6.72 cc [3.09-10.35] vs 5.53 cc [2.21-8.85]) nor radiographic alterations differed between the 2 groups (P > .05). Moreover, the swallowed (16.62 cc [8.45-24.79]) and aspirated amounts of iohexol were not correlated with radiologic changes or deterioration (P > .05). Switching to oral feeding following WSS was more frequent (164 patients: 44.9%), whereas aspiration pneumonia was not (P = .00). WSS did not prolong the interval to patient discharge (P = .06) or induce an allergic reaction or chemotoxicity over 1 week. The absence of aspiration-induced complications and adverse drug effects suggests that, compared with MBSS, WSS may increase aspiration sensitivity and early switching to oral feeding.
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Trastornos de Deglución , Neumonía por Aspiración , Bario , Estudios de Casos y Controles , Preescolar , Medios de Contraste/efectos adversos , Deglución , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/complicaciones , Trastornos de Deglución/diagnóstico por imagen , Humanos , Yohexol/efectos adversos , Neumonía por Aspiración/inducido químicamente , Neumonía por Aspiración/diagnóstico por imagen , Estudios Prospectivos , AguaRESUMEN
BACKGROUND & AIMS: Studies with limited sample sizes have investigated association of chronic opioid use with motility disorders of esophagogastric junction and esophageal body peristalsis. Our aims were to use a large cohort of patients to assess (1) the impact of opioid exposure on clinical and manometric characteristics, and (2) the association of opioid exposure with higher long-term symptom burden. METHODS: Patients recruited from a tertiary medical center who underwent high-resolution manometry (HRM) between 2007 and 2018 were included. Demographics, opiate exposure, clinical symptoms, and HRM parameters were compared. Patient-Reported Outcomes Measurement Information System-Gastrointestinal swallowing domain (PROMIS-GI swallowing domain) and Eckardt score were administered via phone interviews in patients with hypercontractile esophagus (HE) or distal esophageal spasm (DES) to determine long-term symptom burden between opioid and nonopioid users. RESULTS: Our cohort included 4075 patients (869 with opiate exposure with median morphine milligram equivalent [interquartile range] of 30 [10-45]). Patients in the opioid group were significantly more likely to have dysphagia (65% vs 51%, P < .01) and diagnosis of DES (11% vs 5%, P < .01) and HE (9% vs 3%, P < .01). Partial opioid agonists were not associated with motility abnormalities. Patients on opioids had significantly higher symptom burden on median (interquartile range) follow-up of 8.9 years (5.8-10.4) post manometric diagnosis with median PROMIS-GI swallowing domain score of 21.5 (17-25) compared with the nonopioid group at 15 (9.8-21, P = .03). CONCLUSIONS: Nearly 2 of 3 patients with opioid exposure undergoing HRM have dysphagia and more than 25% of them with dysphagia as the primary symptom have a diagnosis of either DES or HE. Opioid users with spastic disorders have higher symptom burden long-term compared with nonopioid users.
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Trastornos de Deglución , Acalasia del Esófago , Trastornos de la Motilidad Esofágica , Alcaloides Opiáceos , Analgésicos Opioides/efectos adversos , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/etiología , Acalasia del Esófago/complicaciones , Trastornos de la Motilidad Esofágica/diagnóstico , Esfínter Esofágico Inferior , Humanos , Manometría , Estudios RetrospectivosRESUMEN
Risk factors for oropharyngeal dysphagia (OD) in elderly patients are mainly central nervous system (CNS) and structural organic diseases or presbyphagia. We analysed the OD prevalence and association of OD with multimorbidity and polypharmacy using real-life data to complete this spectrum, with a focus on further and iatrogenic risk. This was a cross-sectional retrospective study based on a random sample of 200 patients admitted to a geriatric hospital. Data analysis included diagnoses, the detailed list of drugs, and an intense clinical investigation of swallowing according to Stanschus to screen for OD in each patient. The mean patient age was 84 ± 6.5 years. The prevalence of OD was 29.0%, without an effect of age, but a higher rate was found in men and in nursing home residents and an elevated risk of pneumonia. OD risk was slight in diabetes mellitus and COPD, and pronounced in CNS diseases. A relevant OD association was found, even after adjusting for CNS diseases, with antipsychotics, benzodiazepines, anti-Parkinson drugs, antidepressants, and antiepileptics. Further risk of OD was found with beta-blockers, alpha-blockers, opioids, antiemetics, antivertiginosa or antihistamines, metoclopramide, domperidone, anticholinergics, loop diuretics, urologics, and ophthalmics. From real-life data in patients with and without CNS diseases, we identified drug groups associated with a risk of aggravating/inducing OD. Restrictive indications for these drugs may be a preventative contribution, requiring implementation in dysphagia guidelines and an integrative dysphagia risk scale that considers all associated and cumulative medication risks in addition to diseases.
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Antipsicóticos/efectos adversos , Trastornos de Deglución/epidemiología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Deglución , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/complicaciones , Femenino , Humanos , Masculino , Prevalencia , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Lithium is an effective treatment option for bipolar disorder in children and adolescents; however, the therapeutic window is narrow, and psychiatric, neurological, renal, gastrointestinal, dermatological, and endocrine side effects have been observed during lithium therapy.1 Iatrogenic dysphagia has been reported with psychotropic drugs, benzodiazepines, anti-inflammatory drugs, and some vasoactive drugs.2 However, oropharyngeal dysphagia due to lithium toxicity has not been reported in the literature.
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Trastorno Bipolar , Trastornos de Deglución , Adolescente , Antidepresivos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Niño , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/tratamiento farmacológico , Humanos , Litio/uso terapéutico , Psicotrópicos/uso terapéuticoAsunto(s)
Trastornos Psicóticos Afectivos/tratamiento farmacológico , Antipsicóticos/efectos adversos , Trastornos de Deglución/inducido químicamente , Olanzapina/efectos adversos , Anciano , Antipsicóticos/administración & dosificación , Humanos , Masculino , Olanzapina/administración & dosificación , Factores de TiempoRESUMEN
Background: Impassable caustic esophageal strictures (CES) can be rendered passable through sophisticated dilatation techniques, hence avoiding the esophageal replacement surgery and its complications. Patients and Method: Patients with impassable CES who were presented to our hospital between January 2015 and April 2020 underwent a combined balloon and bougie dilatation. This technique aims at doing an initial partial dilatation of the proximal segment of the stricture, using a balloon catheter to pave the way for the endoscope to be advanced more distally. Therefore, a guide wire could be passed down to the stomach to complete the dilatation session using bougie dilators. Results: Seven patients out of 138 patients who underwent endoscopic dilatation for CES at the pediatric surgery department were enrolled in this study. Their ages ranged from 2.5 to 6 years. This technique was successful in 6 patients indicating technique reproducibility of 85.7%. These 6 patients continued their next dilatation sessions using bougie dilator only, whereas 4 patients were completely cured from dysphagia indicating technique efficiency of 57%, 1 is still on dilatation, and 1 patient had a resistant stricture. The dilatation through the proposed technique failed in 1 patient, who was referred for a replacement surgery. Conclusion: Combined dilatation is safe and effective to preserve the native esophagus in some difficult CES.
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Trastornos de Deglución/terapia , Dilatación/métodos , Estenosis Esofágica/terapia , Quemaduras Químicas/complicaciones , Cáusticos/toxicidad , Niño , Preescolar , Trastornos de Deglución/inducido químicamente , Endoscopía Gastrointestinal , Estenosis Esofágica/inducido químicamente , Femenino , Humanos , Masculino , Reproducibilidad de los ResultadosAsunto(s)
Antipsicóticos/efectos adversos , Trastornos de Deglución/inducido químicamente , Síndrome Neuroléptico Maligno/etiología , Antipsicóticos/administración & dosificación , Femenino , Humanos , Síndrome Neuroléptico Maligno/fisiopatología , Trastornos Psicóticos/tratamiento farmacológico , Adulto JovenAsunto(s)
Trastornos de Deglución/inducido químicamente , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Neuropatías Diabéticas/inducido químicamente , Hipoglucemiantes/efectos adversos , Insulina Detemir/efectos adversos , Femenino , Hemoglobina Glucada , Humanos , Hipoglucemiantes/administración & dosificación , Insulina Detemir/administración & dosificación , Persona de Mediana Edad , Aspiración Respiratoria , Insuficiencia RespiratoriaAsunto(s)
Inhibidores de Puntos de Control Inmunológico/efectos adversos , Melanoma/tratamiento farmacológico , Enfermedades Musculares/inducido químicamente , Miositis/inducido químicamente , Miotonía Congénita/complicaciones , Distrofia Miotónica/complicaciones , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Neoplasias Cutáneas/tratamiento farmacológico , Anciano , Anticuerpos Monoclonales Humanizados/efectos adversos , Cardiomiopatía Dilatada , Canales de Cloruro/genética , Conectina/genética , Trastornos de Deglución/inducido químicamente , Trastornos de Deglución/complicaciones , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/fisiopatología , Electrodiagnóstico , Electromiografía , Humanos , Ipilimumab/efectos adversos , Imagen por Resonancia Magnética , Masculino , Melanoma/secundario , Enfermedades Musculares/complicaciones , Enfermedades Musculares/genética , Enfermedades Musculares/fisiopatología , Miositis/complicaciones , Miositis/diagnóstico , Miositis/fisiopatología , Miotonía Congénita/diagnóstico , Miotonía Congénita/genética , Miotonía Congénita/fisiopatología , Distrofia Miotónica/diagnóstico , Distrofia Miotónica/fisiopatología , Conducción Nerviosa , Nivolumab/efectos adversos , Parestesia/inducido químicamente , Parestesia/complicaciones , Parestesia/fisiopatología , Enfermedades del Sistema Nervioso Periférico/complicaciones , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Proteínas de Unión al ARN/genética , Neoplasias Cutáneas/patología , Neoplasias de la Columna Vertebral/tratamiento farmacológico , Neoplasias de la Columna Vertebral/secundarioRESUMEN
Antipsychotic drugs have the ability to induce dysphagia. The aim of this study was to determine the association between the receptor affinity of antipsychotic drugs and the time-to-onset of dysphagia, and to identify factors that prevent antipsychotic drug-induced dysphagia. We used the receptor affinity of 13 antipsychotic drugs for which data were reported in an in vitro test using human receptors, extracted time-to-onset dysphagia from the Japan Adverse Drug Event Report database, and used data from 46 patients to evaluate the correlation between receptor affinity and time-to-onset of dysphagia. We found a negative correlation between D2 receptor affinity and time-to-onset of dysphagia (r = -0.4572, p = 0.0016), and a positive correlation between H1, M1, and M3 receptor affinity and time-to-onset of dysphagia (r = 0.5006, p = 0.0006; r = 0.4130, p = 0.0059; and r = 0.4149, p = 0.0057, respectively). Antipsychotic drugs with a strong D2 receptor-blocking action may accelerate the onset of dysphagia, whereas a strong H1, M1, and M3 receptor-blocking action may delay the onset of dysphagia. The current study revealed the relationship between the receptor affinity of antipsychotic drugs and the time-to-onset of dysphagia, which should aid in the selection of antipsychotic drugs, while preventing dysphagia.
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Antipsicóticos/efectos adversos , Trastornos de Deglución/inducido químicamente , Antagonistas de los Receptores de Dopamina D2/efectos adversos , Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Anciano , Antipsicóticos/administración & dosificación , Antipsicóticos/farmacología , Bases de Datos Factuales , Trastornos de Deglución/prevención & control , Antagonistas de los Receptores de Dopamina D2/administración & dosificación , Antagonistas de los Receptores de Dopamina D2/farmacología , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
PURPOSE OF REVIEW: Dysphagia is a debilitating, depressing and potentially life-threatening complication in cancer patients that is likely underreported. The purpose of this review is to critically synthesize the current knowledge regarding the impact of chemotherapeutic regimens on swallowing function. RECENT FINDINGS: Those patients with cancers involving the aerodigestive tract, head and neck cancer and oesophageal cancer are at highest risk of developing dysphagia. The most common dysphagia causing toxicity of chemotherapeutic agents is mucositis/stomatitis. The use of cisplatin is correlated with increased incidence of mucositis. Similarly, the addition of melphalan is also associated with worsening mucositis and dysphagia. In some cases of oesophageal cancer, thyroid cancer, metastatic lung or breast cancer the use of chemotherapy can improve swallow function as obstructive lesions are reduced. SUMMARY: There is limited literature regarding the role of chemotherapy in the development or treatment of dysphagia. Most dysphagia that occurs during cancer treatment is attributable to radiation or the synergistic effect of radiation and chemotherapy. Patients with disordered swallowing prior to treatment have the greatest risk of developing posttreatment dysphagia. Studies are needed to determine whether acute inflammation associated with oropharyngeal mucositis predisposes for late dysphagia.