Head and neck surgery makes swallowing difficult because the surgery may remove or damage important structures like your tongue, throat, or voice box, and can harm the nerves that control your swallowing muscles. This makes your muscles weak or unable to work together properly.After surgery, swelling and scar tissue make it harder for food to pass through your throat. Pain, medications, and breathing tubes can make swallowing even more challenging but speech therapy can help patients adapt and improve their swallowing abilities.