Swallowing after transoral surgery: tubes, tests and getting back to food | CION Cancer Clinics

Most people swallow by mouth again after transoral surgery, but how soon depends on how much was removed and from where. After a small laser operation on a vocal cord, many people are eating soft food very soon. After TORS on the tonsil or tongue base, or laser surgery above the vocal cords, it can take weeks, and some people need a feeding tube for a while.

Why swallowing is affected

Swallowing needs the tongue base, the throat walls and the lid over the voice box to work together in a split second. Surgery through the mouth leaves these muscles largely in place, which is its main advantage over older open operations. But the raw area is sore, the tissue is swollen, and the part that was removed no longer helps push food down.

Aspiration, the risk the team watches for

Aspiration means food or drink going into the windpipe instead of the food pipe. It can cause coughing while eating, or no cough at all, and it can lead to a chest infection. This is why the team checks your swallow before you eat, rather than letting you simply try.

Laser surgery and TORS are not the same here

Laser surgery on one vocal cord removes tissue that plays little part in moving food, so swallowing is often barely affected. TORS on the tongue base, or laser surgery on the area above the vocal cords, works on the very structures that push food down and guard the airway. Recovery after those operations is slower, and more support is usually needed.

Recovery is usually slower after a larger removal, after surgery on the tongue base or the area above the vocal cords, and when radiotherapy follows. It can also be harder for older people, for anyone who had swallowing trouble before surgery, and after earlier radiotherapy to the neck. Weight loss before the operation makes it harder again.

What to ask before the operation

Ask whether a feeding tube is likely, and roughly for how long. Ask whether you will meet a swallowing therapist beforehand, because starting exercises early can help. Ask what support there is after discharge, especially if you live far from the hospital.

What this page cannot tell you

It cannot tell you how your own swallowing will recover. That depends on exactly what was removed, what treatment follows and your health before surgery. Your surgeon and therapist can give you a realistic picture. If progress seems to stall, or eating is getting harder rather than easier, say so at the next review, or sooner if you are losing weight.