Swallowing after pharyngeal reconstruction | CION Cancer Clinics

Most people learn to swallow and eat by mouth again after a laryngopharyngectomy, once the new throat has healed. Eating is usually slower than before, and softer or moister food is often easier. It takes weeks to months of practice, with help from a swallowing therapist and a dietitian.

Why swallowing feels different

Your old throat had muscles that squeezed food down in a timed wave. The new tube, whether it is made from skin, small bowel or stomach, does not squeeze in the same way. Food moves down mostly by gravity and by the push of your tongue. That is why sitting upright, taking small mouthfuls and following food with sips of water helps so much.

One thing that is easier

Your breathing now goes through the stoma in your neck, completely separate from the food passage. Food and drink cannot go down the wrong way into the lungs, as they sometimes do in other throat operations. The exception is a leak around a voice valve, covered below.

What affects how well it goes

The type of repair, whether a join narrows, radiotherapy before or after surgery, and how much practice you put in all make a difference. So does keeping your weight up while you learn.

Not everyone returns to eating fully by mouth. A small group need a feeding tube for a long time, or keep it alongside meals. That is not a failure. It keeps weight and strength up while swallowing improves, or when it does not.

Who tends to find it harder

People who had high-dose radiotherapy to the throat before surgery, whose tissue is scarred and dry. People whose join narrows again after stretching. People who needed further surgery for a leak. People who were already very thin and weak before the operation.

During radiotherapy after surgery

If radiotherapy is given after the operation, the mouth and throat often become sore for a while, and eating can go backwards. The team may rely on the feeding tube during this time. It usually improves once the soreness settles.

Who helps you along the way

A speech and swallowing therapist teaches safe swallowing and checks your progress. A dietitian plans what you eat and when the tube feed can be reduced. The surgeon looks for narrowing or leaks. Keep all three appointments even when eating seems to be going well, because weight loss and early narrowing are easy to miss at home.

What this page cannot tell you

It cannot tell you how well you in particular will swallow, or how long it will take. Ask your swallowing therapist what they expect for your type of repair, and what goals to aim for.