The structure of jugular foramen area is complex, and there are many important blood vessels and nerves passing through, such as jugular vein, linguopharyngeal nerve, vagus nerve and parasympathetic nerve. Therefore, lesions in the jugular foramen area are often accompanied by the dysfunction of these nerves, or the corresponding symptoms appear after tumor removal, such as dorsal soft palate and pharynx sensory disorder, absence of taste in the posterior 1/3 of the tongue; vocal cord and soft palate paralysis, hoarseness, and disappearance of pharyngeal reflex on the diseased side. Swallowing is a series of actions to transport food from the mouth to the stomach. The impaired movement of the tongue and paralysis of the soft palate affect the contraction of the muscles involved in the swallowing action, resulting in insufficient elevation of the intraoral pressure and lack of sufficient power for the movement of food from the mouth to the entrance of the esophagus via the pharynx, leading to retention of the food mass. At the same time, the mucosal reflex in the laryngopharynx is absent or diminished, which can easily lead to misophagy. These changes lead to difficulties in swallowing and eating, which in turn lead to dehydration and malnutrition, making the quality of life significantly reduced. The compensatory process of neurological dysfunction is quite slow, and the correct functional exercise given after surgery helps to accelerate the process of compensation. In 2002, experts from the American Dietetic Association, after a long period of research and conclusion, developed a diet plan for dysphagia, which divides food into solid and liquid foods according to the characteristics of the diet. Patients can choose the right food according to their condition to restore their health and improve their quality of life with a balanced diet. Recognizing the “four levels” of food In general, people usually refer to chunky foods as solid foods and watery foods as liquid foods. Experts from the American Dietetic Association distinguish between the texture of solid foods and the viscosity of liquids according to the characteristics of different foods, which are divided into four levels, truly reflecting the “people-oriented”. First of all, let’s understand solid (semi-solid) food. The first level: paste-like food. It only requires very little chewing ability, such as pudding, jelly. Second level: moist, semi-solid food. It requires some degree of chewing ability, but tends to form food clusters. In daily life, meat that has been grated or cut into small pieces should not exceed 1/4 cubic centimeter in size; soft and tender vegetables after cooking, they should be less than 0.5 centimeter in size. It is worth noting, however, that bread, rice and cheese are not listed. These foods must be sufficiently moistened before entry, for example, by dipping in gravy and sauce, and the food should be cooked to a degree that it can be mashed directly by utensils, so that it can be called “moist semi-solid”. Third level: soft food. It requires better chewing ability, but does not include hard, sticky foods. Usually, bread, rice, chopped vegetables and moist meat can be chosen. During eating, be sure to avoid nuts. Hard foods tend to cause difficulty in swallowing and are more likely to cause wound bleeding. The fourth level, defined as “normal”, is commonly referred to as “all foods”. When choosing food, it is important to clarify the relationship between disease and diet, to choose food correctly, and to avoid partial eating and waste eating. Reasonable arrangement of the number of meals, the habit of regular diet, to avoid uneven hunger and satiety. Next, get to know the liquid food, which is likewise divided into four levels according to the nature of the liquid. The first level: thin, its viscosity 1 ~ 50 mPa?s. Figuratively speaking, it is water, juice, milk, soy milk and other flowing liquid. The second level: dew-like, with a viscosity of 51~350 mPa?s. In our daily life, the body wash we use can be called “dew-like”. When this liquid is poured out slowly in a spoon, it can be separated drop by drop. The third level: honey-like, with a viscosity of 351~1750 mPa?s. It is similar to honey in that it appears as a continuous line when poured, and cannot be separated into droplets. Lotus root powder paste and sesame paste belong to the third level. The fourth level, spoon consistency, has a viscosity > 1750 mPa?s. The viscosity of pudding has reached this level, and this type of liquid food sticks together and slides off as a whole when it is poured out slowly. Based on the state of the liquid when poured, we can visually distinguish the four levels of liquid food. Therefore, when choosing liquid food, it is important to differentiate according to the viscosity, not to generalize the whole point, and this way of selection also breaks the traditional concept of liquid food. We should choose the right food for different levels of dysphagia, so that we can improve the effectiveness of treatment and achieve the goal of curing the disease and improving health. The “selection points” of food are clearly defined. Create a comfortable dining environment, instruct patients to do oral exercises related to the tongue and jaw, start with sucking action, suck liquid food with a straw, and then teach patients to close their lips tightly to promote swallowing. After the swallowing function improves, the patient can gradually switch to solid foods. In the process of choosing food, the first thing is to judge the softness of the food, the degree of being able to crush it directly with the tongue and form food blocks, and secondly, the consistency of the food, which should not be too thin or too thick, and to prevent accidental aspiration when eating jelly. In the process of eating, pay attention to the speed and amount of eating. A normal person’s intake is about 20ml, but for people with swallowing difficulties, the intake of one bite is 3-4ml, and it is recommended to feed slowly from the corner of the mouth. If the amount of food is too large, it will cause mis-swallowing due to residue in the pharynx. If the amount of food is too small, it will be difficult to induce the swallowing reflex because the stimulus is not strong enough, so it should be increased from less to more according to the actual situation, as appropriate. Beware of liquid food as an “invisible killer” Many people have a wrong view that if they have difficulty swallowing, they should eat liquid food because it is easy to swallow. In fact, thin liquid food can easily become the “invisible killer”. The fluid, fast-flowing thin liquid food is prone to choking and coughing, leading to aspiration pneumonia. But there are two sides to everything, not enough water can also cause dehydration. Therefore, when choosing liquid food, thickening agents such as thickened fruit juice and lotus root powder can be used appropriately, which prevents aspiration pneumonia and ensures water intake. Proper evaluation of the patient’s nutritional status makes an important reference for the development of a diet plan. Accurately judge the patient’s swallowing and chewing functions and select soft and semi-liquid foods. Using a multifunctional cooking machine or food blender to beat food into a homogeneous paste will change the nature and properties of the food, but still provide energy assurance to the patient.