Table 4 Representative quotes from participants describing dysphagia symptoms after ACSS

Physiological symptoms

Coughing

7 Days

“I cough as soon as I drink water, but I dare not cough too hard, and I have to control it for fear that the wound will crack.” (P2)

6 Weeks

“These days are much better than before. I can drink without a bottle or straw.” (P10)

Swallowing pain

7 Days

“Swallowing saliva is very painful, not to mention eating, yes,it is like a brush brushing my throat.” (P3)

“The doctor gave me a small bottle(10ml) of oral liquid for potassium supplement. I had to swallow it three or four times because of the pain.” (P4)

6 Weeks

“Don’t mention it! I feel pain even if I swallow saliva.” (P2)

6 Months

“Now it has been more than half a year since the operation. I often choke while drinking water.” (P22)

Difficulty with solids

7 Days

“It’s very difficult to eat porridge recently, let alone other food. I can’t swallow it. I’m hungry and have no energy all day.” (P16)

Food getting stuck

7 Days

“I ate some mung bean porridge at noon, and the mung bean has been hanging in my throat, which is very uncomfortable.” (P12)

6 Weeks

“I always feel uncomfortable after eating. I have a feeling of obstruction from the throat to the back of the sternum.” (P11)

6 Months

“I dare not eat fish at all, because it is easy to get stuck by fish bones, which is not like this before.” (P22)

Increased secretion in throat

7 Days

“I think my throat has been blocked by phlegm all day, and sometimes I feel it almost overflows from my wound.” (P8)

“There are many bubble like secretions every day, and a box of such paper (200 sheets) can be used every day.” (P14)

Foreign body sensation in throat

7 Days

“If my cervical vertebra bends forward, this foreign body feeling will be more obvious…The pillow will be uncomfortable if it is high or low.” (P6)

6 Months

“I feel something buried in my throat. But I don’t always have this feeling. It’s paroxysmal.” (P10)

Throat burning sensation

7 Days

“The throat is as dry as burning here. I want to drink water to moisten it, but I can’t drink it.”(P1)

“When I open my mouth and breathe in the cold air, it will hurt my throat, especially at night.” (P8)

The feeling of suffocation

7 Days

“I dare not even sleep. Once I sleep, I feel suffocated.”(P8)

“I always feel hard to breathe at night. The air is thin and I can’t breathe.” (P14)

Food regurgitation

7 Days

“I had an orange for lunch. It didn’t take long for the orange juice to flow back from the esophagus to the mouth.” (P8)

Complications

Lose weight

6 Months

“I just eat little thing, and I have no strength. I went to weigh myself, and I’ve lost 5 kg in recent months.” (P15)

“My weight is 4 kg lighter than before, and my hemoglobin is low.” (P19)

Sleep disorders

7 Days

“My throat was dry and painful all night. I need to keep getting up and dropping a few drops of water in my throat. After all, I can’t drink too much at one time.” (P7)

Anorexia

6 Months

“During this period, if I am not very hungry, I will not want to eat.” (P16)

Tension before eating

6 Months

“Once I want to swallow something, I am very nervous because I know I have to suffer again.” (P2)

Negative effects of dysphagia on psychology

Be anxious about the outcome of the operation

6 Weeks

“At this time, I was worried whether the reason why I couldn’t swallow anything was because the operation was not done well. I might have to have another operation.” (P8)

“I have an operation wound on my neck, but I have been coughing all the time. I want to control it, but I can’t control it. This situation will make me recover slowly.” (P12)

7 Days

Be anxious about self nutrition

6 Weeks

“What should I do? I took a lot of blood for test before the operation, but now I can’t eat and my nutrition can’t keep up. Now all my pain is in my throat.” (P5)

Depressive emotions

6 Weeks

“I have been very scared these days. I had a friend who couldn’t swallow anything. As a result, he was diagnosed with laryngeal cancer(Whimper)…” (P4)