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Head and Neck Cancer Studies / Salivary Gland Disorders and Functions · Journal article
The Laryngoscope · August 18, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective case series of 142 head and neck cancer patients with velopharyngeal dysfunction identified associations between advanced T stage, radiation dose, and VPD occurrence, with shorter symptom latency after surgery than radiation-based therapies. The work is descriptive and hypothesis-generating; it does not establish causation, quantify effect sizes, or compare outcomes to a control population, and highlights measurement inconsistency as a barrier to standardization in this population.
Retrospective case series. Patients with head and neck cancer who developed velopharyngeal dysfunction-related symptoms; enrolled across three tertiary centres. Intervention: Head and neck cancer treatment (surgery and/or radiation-based therapies). n = 142. Three tertiary centres (specific locations not specified in source).
Advanced-stage disease (T3-T4) was associated with nasal regurgitation in patients with VPD Higher radiation dose showed a dose-response relationship with endoscopic evidence of velopharyngeal insufficiency Radiation dose association was observed for endoscopic outcomes but not for clinical outcomes (hypernasality, regurgitation, intelligibility)
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Clinicians should recognize VPD as a potential sequela of head and neck cancer treatment, particularly in patients with advanced-stage disease or who receive higher radiation doses. The inconsistent measurement approaches across institutions highlight the need for standardized assessment protocols to improve early identification and management of this complication.
A retrospective, multi-centre case series identifying risk factors for velopharyngeal dysfunction after head and neck cancer treatment, without a control arm or prospective design; raises associations but does not establish causation or quantify effect sizes.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize VPD as a potential sequela of head and neck cancer treatment, particularly in patients with advanced-stage disease or who receive higher radiation doses. The inconsistent measurement approaches across institutions highlight the need for standardized assessment protocols to improve early identification and management of this complication.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
OBJECTIVE(S): To characterize the clinical features and risk factors associated with velopharyngeal dysfunction (VPD) following head and neck cancer (HNC) treatment. METHODS: Patients with HNC and subsequent VPD-related symptoms were identified through electronic query and manual chart review across three tertiary centers. Demographic, oncologic, and treatment variables, including tumor subsite, T stage, treatment modality, and radiation dose, were collected. VPD-related outcomes included hypernasality, nasal regurgitation, reduced intelligibility, and evidence of velopharyngeal insufficiency on endoscopy. Associations were evaluated using univariate tests and logistic regression, with radiation dose modeled as a continuous variable. RESULTS: A total of 142 patients met inclusion criteria. The most common primary tumor subsites in this cohort were oropharyngeal and oral cavity. Advanced-stage disease (T3-T4) was more common than early-stage disease (Tis-T2) and was associated with nasal regurgitation. Higher radiation dose was associated with increased likelihood of endoscopic VPD, with a dose-response relationship observed; however, this association was not observed for clinical outcomes. Latency to VPD onset varied by treatment modality, with shorter latency following surgery and longer latency following radiation-based therapies. Speech-language pathology (SLP) evaluation was commonly performed; however, standardized symptom outcome metrics and instrumental assessments were inconsistent and underutilized across institutions. CONCLUSION: VPD is an underrecognized sequela of HNC treatment, and may be associated with primary tumor subsite, advanced disease, and radiation dose. Treatment modality contributes to latency in VPD diagnosis. Variability in SLP evaluation and outcome measurement highlights the need for more standardized assessment approaches to improve identification and management of VPD in this population.
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