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.
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