Aspiration
When there is involvement of the recurrent laryngeal nerve, it can cause paralysis of the laryngeal muscles, which increases the risk of aspiration of food into the trachea and the lungs. Aspiration can be caused by the mechanical blockage of the esophagus by the tumor mass due to regurgitation of food. It can also be due to the spread of tumor, which may lead to the formation of a tracheoesophageal fistula or Broncho esophageal fistula between esophagus and the airway. This also leads to aspiration through the fistula connection.