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S157: NASOPHARYNGEAL REGURGITATION OUTCOMES FOLLOWING NASOPHARYNGEAL CARCINOMA TREATMENT
Jack Birkenbeuel, MD, MBA; Neil Thakkar, BS; Eric Nisenbaum, MD; Ricardo Carrau, MD, MBA; Kyle Vankoevering, MD; The Ohio State University

Background: Radiotherapy, with or without chemotherapy, remains the cornerstone of treatment for nasopharyngeal carcinoma (NPC). Dysphagia is a frequent post-treatment complication, affecting all phases of swallowing. Despite its clinical relevance, the prevalence of nasopharyngeal regurgitation—a key manifestation of velopharyngeal dysfunction—remains underreported in this population.

Objective: To determine the prevalence of nasopharyngeal regurgitation following NPC treatment and to evaluate potential predictors of this complication.

Methods: A retrospective cohort study was conducted at a high-volume tertiary referral center, including all NPC patients treated between 2000 and 2024. Data collected included sociodemographic factors (age, sex, race, smoking status), tumor characteristics (grade, stage), treatment modality, and presence of nasopharyngeal regurgitation. Regurgitation was defined by objective findings on flexible endoscopic evaluation of swallowing and/or modified barium swallow. Predictors were assessed using binomial logistic regression analyses.

Results: A total of 159 patients met inclusion criteria (mean age: 54 ± 15 years). Objective evidence of nasopharyngeal regurgitation was observed in 17 patients (10.7%). Most patients received primary radiation therapy (94.3%), with 88.1% undergoing concurrent chemoradiation. The mean radiation dose was 67.6 ± 9.5 Gy. Univariable and multivariable logistic regression revealed no statistically significant predictors of nasopharyngeal regurgitation (all p > 0.05).

Conclusions: Nasopharyngeal regurgitation is a notable post-treatment finding in NPC patients, affecting over 10% of individuals based on objective assessment. This likely underrepresents the true burden of velopharyngeal insufficiency in this population. Further research is warranted to better identify risk factors and guide targeted interventions aimed at improving swallowing outcomes.

 

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