Optimizing Respiratory-Swallowing Coordination in Patients With Oropharyngeal Head and Neck Cancer Swallowing impairment (dysphagia) represents the highest functional morbidity in oropharyngeal (OP) head and neck (HNC) treated either with surgical approaches followed by radiation or with more recent organ preservation protocols, including combined chemotherapy and radiation. Despite the promising overall increasing survival rates, swallowing impairments remain chronic, are often resistant to ... Article
Article  |   July 31, 2017
Optimizing Respiratory-Swallowing Coordination in Patients With Oropharyngeal Head and Neck Cancer
Author Affiliations & Notes
  • Bonnie Martin-Harris
    Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL
  • Kendrea L. (Focht) Garand
    Department of Speech Pathology and Audiology, College of Allied Health Professions, University of South Alabama, Mobile, AL
  • David McFarland
    School of Speech Therapy and Audiology, Université de Montréal, Montreal, Quebec
  • Disclosures
    Disclosures ×
  • Financial: This work was partially supported by the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health under award number 1R21DC010480-A1 (PI: Martin-Harris); and the Veteran Affairs under award number RR&D C7135R (PI: Martin-Harris).
    Financial: This work was partially supported by the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health under award number 1R21DC010480-A1 (PI: Martin-Harris); and the Veteran Affairs under award number RR&D C7135R (PI: Martin-Harris).×
  • Nonfinancial: Bonnie Martin-Harris has no relevant nonfinancial interests to disclose. Kendrea L. (Focht) Garand has no relevant nonfinancial interests to disclose. David McFarland has no relevant nonfinancial interests to disclose.
    Nonfinancial: Bonnie Martin-Harris has no relevant nonfinancial interests to disclose. Kendrea L. (Focht) Garand has no relevant nonfinancial interests to disclose. David McFarland has no relevant nonfinancial interests to disclose.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Part 3
Article   |   July 31, 2017
Optimizing Respiratory-Swallowing Coordination in Patients With Oropharyngeal Head and Neck Cancer
Perspectives of the ASHA Special Interest Groups, July 2017, Vol. 2, 103-110. doi:10.1044/persp2.SIG13.103
History: Received February 7, 2017 , Revised March 13, 2017 , Accepted March 13, 2017
Perspectives of the ASHA Special Interest Groups, July 2017, Vol. 2, 103-110. doi:10.1044/persp2.SIG13.103
History: Received February 7, 2017; Revised March 13, 2017; Accepted March 13, 2017

Swallowing impairment (dysphagia) represents the highest functional morbidity in oropharyngeal (OP) head and neck (HNC) treated either with surgical approaches followed by radiation or with more recent organ preservation protocols, including combined chemotherapy and radiation. Despite the promising overall increasing survival rates, swallowing impairments remain chronic, are often resistant to traditional swallowing therapy, and have devastating consequences on health and well-being. The respiratory-swallow cross-system approach presented here extends beyond traditional swallowing interventions that commonly targets muscles and structures alone, and is instead, directed toward the re-establishment of optimal respiratory-swallowing coordination.

Results from our work investigating a respiratory-swallow treatment (RST) paradigm is presented, including results from an RST clinical trial in HNC patients, primarily with OP cancers, with chronic and with intractable dysphagia post-cancer and post-traditional swallowing treatment. Future work will investigate the impact of RST on the degree and durability of clinical outcomes, including oral intake and quality of life, while also examining the potential added benefits of a home practice program that uses a commercially available and easy to use recording and analysis hardware and software.

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