{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:51:06Z","timestamp":1792731066473,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100013026","name":"Hunter Cancer Research Alliance","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To examine the relationship between chronic external and internal head and neck lymphedema (HNL) and swallowing function in patients following head and neck cancer (HNC) treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010nine participants, 1\u20103\u2009years post treatment were assessed for external HNL using the MD Anderson Cancer Centre Lymphedema Rating Scale, and internal HNL using Patterson's Radiotherapy Edema Rating Scale. Swallowing was assessed via instrumental, clinical and patient\u2010reported outcome measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HNL presented as internal only (68%), combined external\/internal (29%), and external only (1%). Laryngeal penetration\/aspiration was confirmed in 20%. Stepwise multivariable regression models, that accounted for primary site, revealed that a higher severity of external HNL and internal HNL was associated with more severe penetration\/aspiration (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.004 and <jats:italic>P<\/jats:italic> = .006, respectively), diet modification (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001 both), and poorer patient\u2010reported outcomes (<jats:italic>P<\/jats:italic> = .037 and <jats:italic>P<\/jats:italic> = .014, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increased swallowing issues can be expected in patients presenting with more severe external HNL and\/or internal HNL following HNC treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26484","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T08:56:47Z","timestamp":1601542607000},"page":"255-267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Association between external and internal lymphedema and chronic dysphagia following head and neck cancer treatment"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7752-5655","authenticated-orcid":false,"given":"Claire","family":"Jeans","sequence":"first","affiliation":[{"name":"Division of Speech Pathology School of Health and Rehabilitation Sciences, The University of Queensland  Brisbane Queensland Australia"},{"name":"Speech Pathology Department Calvary Mater Newcastle  Waratah New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth 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E.","family":"Vertigan","sequence":"additional","affiliation":[{"name":"Speech Pathology Department John Hunter Hospital and Belmont Hospital  New Lambton Heights New South Wales Australia"},{"name":"School of Medicine and Public Health The University of Newcastle  Callaghan New South Wales Australia"},{"name":"Centre for Asthma and Respiratory Disease Hunter Medical Research Institute  New Lambton Heights New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda E.","family":"Pigott","sequence":"additional","affiliation":[{"name":"Centre for Functioning and Health Research Metro South Health Services District, Queensland Health  Buranda Queensland Australia"},{"name":"Division of Occupational Therapy, School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Queensland Australia"},{"name":"Occupational Therapy Department Princess Alexandra Hospital  Woolloongabba Queensland 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