Respiratory Phase Training Effects on Swallow Impairment in Oropharyngeal Cancer

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DESCRIPTION (provided by applicant): Swallowing impairment (dysphagia) is a functional morbidity that impacts the majority of patients treated for cancers of the oropharynx. Many patients remain chronically dysphagic long after their cancer treatments affecting their nutrition, health, and quality of life. Recent preliminary data have shown significant differences between healthy, normal individuals and patients treated for oropharyngeal cancers in respiratory-swallow phase relationships and their association with aspiration and dysphagia. The immediate goal of this phase I clinical trial is to test the effect of a novel respiratory-swallow intervention on swallowing impairment and aspiration in a cohort of chronically dysphagic patients following treatment for oropharyngeal cancer. Patients presenting with a "non-optimal" respiratory-swallow phase pattern during liquid swallows and measurable swallowing impairment will learn an "optimal" physiologic pattern that facilitates both airway protective and mechanical advantages during swallowing. The broad goal of this research is to develop ideal respiratory- swallowing phase training methods and regimens that alone or combined with traditional swallowing treatments improve the swallowing function and reduce aspiration in the acute phases of recovery. Our intention is to use these preliminary data to motivate a larger clinical trial, if warranted, and expand the approach to other patient groups that have indications of respiratory-swallow phase impairments (e.g. pulmonary disease and stroke). PUBLIC HEALTH RELEVANCE: The immediate goal of this clinical trial is to test the effect of a novel respiratory-swallow intervention on swallowing impairment and aspiration in a cohort of chronically dysphagic patients who have been treated for oropharyngeal cancer. Data obtained from this exploratory clinical trial will be used to develop a larger clinical trial and expand the approach to other patient groups that have indications of respiratory-swallow phase impairments.