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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21DC010480-01A1
Application #
7659994
Study Section
Motor Function, Speech and Rehabilitation Study Section (MFSR)
Program Officer
Shekim, Lana O
Project Start
2009-08-11
Project End
2011-07-31
Budget Start
2009-08-11
Budget End
2010-07-31
Support Year
1
Fiscal Year
2009
Total Cost
$221,250
Indirect Cost
Name
Medical University of South Carolina
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
183710748
City
Charleston
State
SC
Country
United States
Zip Code
29425
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Martin-Harris, Bonnie; Garand, Kendrea L Focht; McFarland, David (2017) Optimizing Respiratory-Swallowing Coordination in Patients With Oropharyngeal Head and Neck Cancer. Perspect ASHA Spec Interest Groups 2:103-110
Pearson Jr, William G; Taylor, Brandon K; Blair, Julie et al. (2016) Computational analysis of swallowing mechanics underlying impaired epiglottic inversion. Laryngoscope 126:1854-8
McFarland, D H; Martin-Harris, B; Fortin, A-J et al. (2016) Respiratory-swallowing coordination in normal subjects: Lung volume at swallowing initiation. Respir Physiol Neurobiol 234:89-96
Martin-Harris, Bonnie; McFarland, David; Hill, Elizabeth G et al. (2015) Respiratory-swallow training in patients with head and neck cancer. Arch Phys Med Rehabil 96:885-93
Brodsky, Martin B; McFarland, David H; Michel, Yvonne et al. (2012) Significance of nonrespiratory airflow during swallowing. Dysphagia 27:178-84