Background:
Oropharyngeal dysphagia with aspiration is a recognised consequence of head and neck radiotherapy. Expiratory Muscle Strength Training (EMST) has been shown to improve swallowing in patients with chronic radiotherapy-associated dysphagia (RAD), although the evidence is currently limited to a small number of studies. It is unclear whether improvements are maintained over time.
Methods:
We completed a case study comparing videofluoroscopic swallow evaluation in a patient with chronic RAD at baseline (3 years following radical chemoradiotherapy for oropharyngeal SCC) and again at 6 months after commencing EMST (5 weeks of intensive training followed by a maintenance regime). The outcomes of interest are the Penetration-Aspiration Scale and Dynamic Imaging Grade of Swallowing Toxicity.
Results:
Swallow safety and efficiency scores, as measured using the validated tools above, were superior in the second videofluoroscopy. The difference in Penetration-Aspiration score for thin liquids was well above the threshold for clinically significant change.
Conclusions:
The durability of gains in swallowing function from EMST in chronic RAD are unknown. This case study suggests that improvements in swallowing may last beyond the immediate post-training time point and into the maintenance phase. Further research on long-term benefits of EMST for head and neck cancer survivors is needed.