1. The Effects of Neuromuscular Electrical Stimulation on Dysphagia Secondary to Head and Neck Cancer
Hollee N. Eastwood, B.S. Ed.
Melissa A. Carter, M.S., CCC-SLP
Katie M. Walden, M.S., CCC-SLP

2. Disclosures
No authors had any financial or non-financial conflicts of interest associated with the content of this presentation.

3. Introduction Dysphagia is difficulty with any phase of the swallow.
Causes of dysphagia:
Neurological: stroke
Muscular: myasthenia gravis
Obstructive: head and neck cancer
Treatment for head and neck cancer can lead to dysphagia.
Neuromuscular electrical stimulation used in conjunction with dysphagia therapy is a recent tool in swallowing rehabilitation.

4. Purpose
This study investigated if neuromuscular electrical stimulation will have an effect on residue in the pharyngeal area in head and neck cancer patients.

5. Participant The participant was one74 year old male.
Stage 3 head and neck cancer
33 radiation treatments in 2000
Partial glossectomy
Reconstruction of tongue

6. Methods Therapy exercises: Food trials:
Effortful swallow
Mendelsohn maneuver
Modified Shaker
Food trials:
Puree consistencies
Soft solid consistencies
Solid consistencies
Seven point rating scale used to examine pharyngeal residue.

7. Instrumentation Fiberoptic endoscopic evaluation of swallowing (FEES)
Completed all exercises and trials while utilizing VitalStim NMES, placement 3b, 12mAMp, for minutes for 12 sessions.

8. Results

9. Discussion
This study has demonstrated that the use of neuromuscular electrical stimulation could be beneficial to swallowing abilities, visualized by less pharyngeal residue.
Before treatment the participant presented with an average score of 4 or mild to moderate pharyngeal residue.
After treatment the participant presented with an average score of 3 or mild pharyngeal residue.

10. Limitations Small participant size
Consistency of bolus used in pre-treatment and post-treatment FEES
Extended period of time since initial radiation treatments
Previous swallowing therapy

11. Recommendations In a future study, larger sample size.
Precisely measure bolus size for FEES.
Use participants that have never had swallowing therapy previously.
Clinical recommendation: Neuromuscular electrical stimulation could enhance swallowing abilities.

12. References
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