**2. Dysphagia in HNC patients**

One of the most critical and potentially life-threatening functional problems in patients who are treated for advanced HNC is acute and chronic dysphagia. One of the causes of dysphagia after HNC treatment might be a reduced tongue strength, insufficient contact between the base of tongue and pharyngeal wall, reduced hyolaryngeal elevation, and reduced opening of the upper esophageal sphincter. Due to this altered physiology, the food bolus is swallowed less powerfully, leading to stagnation of food ('residue'), with a high risk of laryngeal penetration or even (silent) laryngeal aspiration of the residue into the trachea. The swallowing problems may worsen when the swallowing musculature is no longer actively used, and the so-called 'non-use' atrophy occurs, causing further deterioration of the swallowing function [10]. Dysphagia (chronic) can lead to reduced body weight, long-term and even lifelong feeding tube dependency, depression, reduced quality of life, aspiration pneumonia and can even lead to death [6, 11, 12].
