<qa>  What was the goal of EBRT?Historically, head and neck cancer management was managed surgically. Though oncologically effective, the transcervical exposure technique along with the tissues removed during the cancer extirpation led to increasing concerns about the functional impact of the therapy, especially as increasing interest in preserving function was sought by investigators and patients. As technical improvements in fractionated external beam radiotherapy EBRT developed in the early 1980s, investigations evaluated and demonstrated that various strategies to intensify EBRT with either concurrent chemotherapy or by altering the radiotherapy fractionation schedule ie. twice daily treatments improved not only local-regional tumour control rates but provided organ preservation. Studies now confirm that the improved local-regional control rates translate into improved survival rates and have led to their acceptance as standard-of-care SOC treatment options. While functional organ preservation was often described as a goal of these investigations, the ability to rigorously define and in fact measure organ function, especially swallow function, was often limited with successful organ preservation largely reflecting the ability to determine anatomic preservation 5. A major reason for this has been the limited spectrum of effective tools to not only measure function especially swallow function but that lend themselves to repeated systematic longitudinal use throughout a course of head and neck cancer treatment especially in follow-up surveillance where manifestations can go unappreciated. As a result, the true prevalence of treatment-related swallow dysfunction in head and neck cancer patients remains unknown, an observation confirmed in a recent multi-national systematic review 6. As noted by the Institute of Medicine, without the ability to measure, we cannot begin to improve upon the outcome 7. 