{
  "abstract": "Background\n\nThis paper presents a comprehensive diagnostic method for coexisting dropped head syndrome (DHS) and dysphagia, both associated with long-term complications of neck radiation. The symptoms reported are common after radiotherapy, but their co-occurrence, causal link, and the years since the initial treatments all contribute to the uniqueness of the case presented. A literature review on the topic is also included.Case presentation\n\nA 54-year-old White male presented with progressive neck extensor weakness consistent with dropped head syndrome (DHS), associated with dysphagia and voice changes, occurring 17 years after radiotherapy for Hodgkin's lymphoma. A comprehensive clinical and instrumental evaluation, including a videofluoroscopic swallowing study (VFSS), electromyography (EMG), and magnetic resonance imaging (MRI), revealed mild-to-moderate dysphagia characterized by reduced swallowing efficiency, with residue in the valleculae and pyriform sinuses (> 50% occupancy) and a Penetration-Aspiration Scale score of 1 (no aspiration). The findings were consistent with postural and neuromuscular alterations involving the cervical region. Bolus clearance improved with manual head support. A structured 2-week rehabilitation program was associated with improved quality of life (as reported by improvement in the SWAL-QOL score) and stable nutritional status, though no objective physiological change was documented on the follow-up electromyographic exam. To our knowledge, this is the first work describing the importance of considering delayed-onset swallowing impairment associated with DHS in patients previously treated with radiotherapy for head-and-neck malignancies.Conclusions\n\nThe co-occurrence of DHS and dysphagia, both related to long-term complications of neck radiation, necessitates a comprehensive diagnostic approach that is currently lacking in the relevant literature. Swallowing assessments and screenings should be standard procedures in the long-term follow-up of tumors affecting the head-and-neck regions. The study underscores the importance of considering neuromuscular pathophysiological and mechanical mechanisms in post-radiotherapy dysphagia.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Biomedical Sciences for Health, University \"La Statale\", Milan, Italy.",
    "Azienda di Servizi alla Persona Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, Milan, Italy.",
    "Medical Rehabilitation Department, Istituto Auxologico Italiano IRCCS, Milan, Italy.",
    "Medical Rehabilitation Department, Istituto Auxologico Italiano IRCCS, Milan, Italy. caterina.calvi@unimi.it.",
    "School of Physical and Rehabilitation Medicine, University \"La Statale\", Milan, Italy. caterina.calvi@unimi.it.",
    "Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, Milan, Italy."
  ],
  "article_type": "review",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Calogero Malfitano"
    },
    {
      "affs": [
        2
      ],
      "name": "Denise Pighetti"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Caterina Calvi",
      "orcid": "0009-0006-8312-3314"
    },
    {
      "affs": [
        2
      ],
      "name": "Camilla Meneguzzo"
    },
    {
      "affs": [
        5
      ],
      "name": "Alberto Doretti"
    },
    {
      "affs": [
        2
      ],
      "name": "Antonio Robecchi Majnardi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2j3ag9c68n3ng.bib",
  "cited_by": 0,
  "doi": "10.1186/s13256-026-06400-5",
  "fulltext_url": "https://europepmc.org/articles/PMC13729638",
  "id": "2j3ag9c68n3ng",
  "issns": [
    "1752-1947"
  ],
  "landing_url": "https://europepmc.org/article/MED/42972390",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "3616|Dysphagia Assessment and Management"
    ]
  ],
  "openalex": "W7172493273",
  "pdf_url": "https://europepmc.org/articles/PMC13729638?pdf=render",
  "pmcid": "PMC13729638",
  "pmid": "42972390",
  "published": "2026-08-05",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/2j3ag9c68n3ng.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42972390",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42972390"
    },
    {
      "first_seen": "2026-11-07T12:22:21Z",
      "native_id": "PMC13729638",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s13256-026-06400-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Challenges in the diagnosis and management of coexisting drop-head syndrome and dysphagia: a case report and review of the literature.",
  "title_text": "Challenges in the diagnosis and management of coexisting drop-head syndrome and dysphagia: a case report and review of the literature.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:21Z",
  "url": "https://research.draconitic.com/paper/2j3ag9c68n3ng",
  "venue": "Journal of medical case reports",
  "versions": []
}