A comprehensive clinical review by Russi et al. (2012) focused on dysphagia as a prevalent and debilitating symptom associated with head and neck cancer (HNC). At diagnosis, as many as two-thirds of patients with HNC present with dysphagia, and about one-third of those may develop aspiration pneumonia with associated mortality rates of 20%-65%. Prior studies have shown pretreatment deficits common in patients with advanced-stage HNC and indicated a poor correlation between measurable deficits and patient deficit perception. The article provides a detailed overview of anatomic and physiologic swallowing mechanisms, along with recommendations for pretreatment swallowing assessments by speech and language therapists to identify the potential syndrome of silent dysphagia, as well as the risk of concomitant aspiration.