This project is a continuation of the project in the current CCSP entitled Biomechanics of Swallow after Head and Neck Cancer. Treatment for head and neck cancer can change not only the range and rate of motion of involved structures during the swallow, that is, the biomechanics of the swallow, by altering the direction and strength of muscle pull or by introducing scar tissue, but may also alter the neural input into the region of treatment. Alterations in the biomechanics of the pharyngeal swallow potentially change its efficiency and safety. Altering neural input may cause difficulty in triggering the pharyngeal swallow which results in food reaching the lower areas of the pharynx too early, also potentially altering swallow safety and efficiency. The major objectives of this study are to increase our understanding of the effects of tumor treatment, recovery, and rehabilitation on the biomechanical and sensory characteristics of the oropharyngeal swallow by: 1) continuing to examine the biomechanical characteristics of the oropharyngeal swallow in individuals and selected groups of treated head and neck cancer patients at 1 week, 1 month, and 3 months post treatment and comparing these with similar data on normal individuals; 2) examining the effects of procedures which enhance sensory input to the oral cavity (bolus taste and volume) on the speed and efficiency of the oropharyngeal swallow in treated head and neck patients at 1 week, 1 month and 3 months post treatment and comparing these to similar data on normal individuals; 3) comparing the patient's ability to produce targeted swallow rehabilitation techniques/maneuvers at 1 week, 1 month, and 3 months post treatment and comparing these to similar measures of normal subjects producing swallow maneuvers; and 4) defining those swallow rehabilitation maneuvers which result in best swallow function for individual patients and specific groups of treated head and neck cancer patients at each point in time post treatment. Swallow maneuvers or voluntary control applied to selected aspects of the pharyngeal swallow and bolus taste can substantially alter oropharyngeal swallow physiology, thus impacting significantly on the patient's ability to return to oral intake. Definition of the bolus characteristics and maneuvers which work best in specific types of patients should enable more rapid and successful return to oral intake.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Program Projects (P01)
Project #
2P01CA040007-11
Application #
5207253
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
11
Fiscal Year
1996
Total Cost
Indirect Cost
Logemann, Jerilyn A (2014) Critical Factors in the Oral Control Needed for Chewing and Swallowing. J Texture Stud 45:173-179
Pauloski, Barbara Roa; Logemann, Jerilyn A; Rademaker, Alfred W et al. (2013) Effects of enhanced bolus flavors on oropharyngeal swallow in patients treated for head and neck cancer. Head Neck 35:1124-31
Pauloski, Barbara Roa; Rademaker, Alfred W; Lazarus, Cathy et al. (2009) Relationship between manometric and videofluoroscopic measures of swallow function in healthy adults and patients treated for head and neck cancer with various modalities. Dysphagia 24:196-203
Logemann, Jeri A; Pauloski, Barbara Roa; Rademaker, Alfred W et al. (2008) Swallowing disorders in the first year after radiation and chemoradiation. Head Neck 30:148-58
Pauloski, Barbara Roa; Rademaker, Alfred W; Logemann, Jerilyn A et al. (2006) Relationship between swallow motility disorders on videofluorography and oral intake in patients treated for head and neck cancer with radiotherapy with or without chemotherapy. Head Neck 28:1069-76
Daggett, Alicia; Logemann, Jeri; Rademaker, Alfred et al. (2006) Laryngeal penetration during deglutition in normal subjects of various ages. Dysphagia 21:270-4
Smith, Christina H; Logemann, Jeri A; Burghardt, Wesley R et al. (2006) Oral and oropharyngeal perceptions of fluid viscosity across the age span. Dysphagia 21:209-17
Logemann, Jeri A; Rademaker, Alfred W; Pauloski, Barbara Roa et al. (2006) Site of disease and treatment protocol as correlates of swallowing function in patients with head and neck cancer treated with chemoradiation. Head Neck 28:64-73
Logemann, Jeri A; Williams, Rohan B; Rademaker, Alfred et al. (2005) The relationship between observations and measures of oral and pharyngeal residue from videofluorography and scintigraphy. Dysphagia 20:226-31
Waters, Teresa M; Logemann, Jeri A; Pauloski, Barbara Roa et al. (2004) Beyond efficacy and effectiveness: conducting economic analyses during clinical trials. Dysphagia 19:109-19

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