Neoplasms

All Conditions

Mouth and Tooth Diseases

Ear, Nose, and Throat Diseases

Rare Diseases

Carcinoma

Nasopharyngeal Carcinoma

Nasopharyngeal Neoplasms

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Pharyngeal Neoplasms

Otorhinolaryngologic Neoplasms

Head and Neck Neoplasms

Nasopharyngeal Diseases

Pharyngeal Diseases

Stomatognathic Diseases

Otorhinolaryngologic Diseases

Yeun-Chung Chang, M.D., Ph.D.

Significant evidence has shown that radiation therapy for patients with nasopharyngeal cancer (NPC) can cause swallowing abnormality. Based on our prior cross-sectional study for 184 NPC patients from 1995 to 1999, the findings of videofluoroscopic swallowing study (VFSS) revealed continuous deterioration of swallowing function of these patients even many years after radiation. We conducted a prospective study to evaluate the longitudinal change of swallowing function based on VFSS before, one month, one year and two years after completing radiation therapy. The amount of saliva was measured at the same time of VFSS study to test the relationship of decreased amount of saliva and swallowing function. Comparison of serial VFSS studies in NPC patients (n=84) and normal volunteers (n=38) were obtained. We assume that this study may reveal a complete understanding of changing swallowing patterns in the course of radiation therapy of patients with NPC. From this study, NPC patients can understand their own swallowing function. Therefore, the information may enable for earlier intervention of swallowing training or correction to avoid morbidity of radiation therapy in this patient group.

Swallowing Pattern of Patients With Nasopharyngeal Cancer Before and After Radiation Therapy: Longitudinal Study and Correction With Saliva Amount

National Taiwan University Hospital

Yeun-Chung Chang

Infections

Nervous System Diseases

Symptoms and General Pathology

Digestive System Diseases

Musculoskeletal Diseases

Respiratory Tract (Lung and Bronchial) Diseases

Behaviors and Mental Disorders

Bell Palsy

Facial Paralysis

Facies

Paralysis

Xerostomia

Deglutition Disorders

Polymyositis

Speech Disorders

Laryngeal Diseases

Dysarthria

Myositis

Muscular Diseases

Neuromuscular Diseases

Language Disorders

Communication Disorders

Neurobehavioral Manifestations

Neurologic Manifestations

Bell's Palsy

Idiopathic Inflammatory Myopathy

This study will assess the use of ultrasound-a test that uses sound waves to produce images-as a diagnostic tool for evaluating speech and swallowing.

The following categories of individuals may be eligible for this study: 1) healthy volunteers between 20 and 85 years old with normal speech and hearing, 2) patients 6 to 85 years old with developmental neurological deficits in speech or swallowing, and 3) patients with tumors of the oral cavity, pharynx or larynx being treated at the Greater Baltimore Medical Center.

Participants will undergo a 30-minute speech and oral motion evaluation, in which they imitate sounds, words and oral movements while a speech pathologist evaluates their lip, tongue and palate movements. They may also be asked to drink a small amount of water for examination of swallowing function.

For the ultrasound examination, a 3/4-inch transducer (device for transmitting and receiving sound waves) is placed under the participant's chin. While the transducer is in place, the subject 1) repeats sounds and a series of syllables in several sequences, 2) swallows three times with and without a small amount of water, and 3) swallows 3 teaspoons of non-fat pudding. The ultrasound images are recorded on tape for later analysis.

Studies conducted using ultrasound imaging at the NIH, Departments of Rehabilitation Medicine and Diagnostic Radiology, have demonstrated that ultrasound imaging can be used reliably to study speech and swallowing impairments in a variety of conditions and diseases. Since ultrasound is non-invasive with no reported bioeffects, it can be used repeatedly to follow the progression of a disease. Ultrasound imaging of the oral cavity during speech and swallowing allows easy visualization of the tongue/hyoid bone motion and transport of the bolus during swallowing and tongue surface configuration during speech. Images can be obtained in several planes for viewing muscular coordination and timing and specific measures can be obtained from digitized video images. Thus it has widespread clinical research implications for patients with disorders affecting the oral peripheral muscles, salivary gland flow and the central nervous system control of speech and swallowing. While ultrasound technology has been used extensively in Europe to evaluate tumors of the head and neck, its use in this country has been marginal. We plan to compare ultrasound evaluation of tumor staging, tumor volume, and tumor recurrence in patients with tumors of the larynx, oral cavity and hypopharynx. Currently, this is accomplished by CT or MRI scanning procedures. We plan to compare CT/MRI results with ultrasound to determine if this non-invasive technique can be utilized reliably for diagnosis and tracking of oropharyngeal tumors.

Ultrasound Evaluation of Tongue Movements in Speech and Swallowing

Exploration of the Diagnostic Capabilities of Ultrasound of the Oropharynx and Larynx

National Institutes of Health Clinical Center (CC)

Oropharyngeal Neoplasms

Esophageal Diseases

Gastrointestinal Diseases

Adult participants who have completed radiation therapy for oropharyngeal cancer within the past 3 months will undergo a swallowing x-ray study in which they will swallow up to 15 liquid stimuli prepared to different consistencies using starch and gum based thickeners.

Barium will be thickened to slightly, mildly, moderately and extremely thick consistences as defined by the International Dysphagia Diet Standardisation Initiative flow test.

Starch-based Thickened Liquids

Xanthan-gum Thickened Liquids

Catriona Steele, PhD

This study is part of a larger grant, for which the overall goal is to collect measurements of liquid flow through the oropharynx (i.e., mouth and throat) during swallowing. The focus of this study is to evaluate the flow of liquids of varying consistency in the head and neck cancer population.

Thickened liquids are commonly used as an intervention for dysphagia (swallowing impairment). However, the field lacks a clear understanding of how liquids of different consistencies behave during swallowing. In order to improve understanding of the effectiveness of altered liquid consistency for improving dysphagia, the investigators are studying liquid flow through the oropharynx.

This study explores this question in individuals who have undergone radiation treatment for head and neck cancer, specifically located in the oropharynx.

Participants will swallow 20% w/v barium thickened to different consistencies (thin, slightly thick, and mildly thick) using commercially available food thickeners. Swallowing will be observed under videofluoroscopy.

Physiological Flow of Liquids in Head and Neck Cancer Patients: A Pilot Study

Swallowing safety was measured using the Penetration-Aspiration Scale, an 8-point categorical scale which captures the depth to which any material enters the airway and whether or not the material is ejected. Levels 1 and 2 on the scale are considered safe, while levels \> 2 are considered unsafe. Actual scale scores (1-8) will be recorded and then converted to binary categorical scores (\< 3 vs \>/= 3). We will report the frequency (count) of participants showing scores \> 2 by bolus consistency.

Residue is material remaining behind in the pharynx after the swallow. We measured residue by tracing the area of barium visible on a lateral view x-ray (in pixels, using ImageJ software) and dividing that area by the squared length C2-C4 cervical spine. This cervical spine scalar provides a common anatomical reference that is a proxy for pharyngeal size, and enables the comparison of residue severity across different people with different neck length and pharynx size. In healthy swallowing, residue is expected to be minimal. We report mean values and standard deviations for amount of residue by consistency (thin, slightly thick, and mildly thick liquids).

Participants rated the palatability of lemon flavored water and liquid barium stimuli in slightly thick, mildly thick and moderately thick consistencies. Palatability was scored using a 9-point hedonic categorical rating system previously described by Pelletier et al. The ratings use 9 descriptors to capture the degree to which a participant likes a stimulus, with anchors of "Dislike extremely" and "Like extremely". Scores of 1-4 indicate liking of a stimulus, a score of 5 is neutral while scores of 6-9 indicate dislike. We dichotomized this scale between scores of 1-4 (liking) and scores of 5-9 and report the number of participants reporting scores of 6-9 (dislike).

National Institute on Deafness and Other Communication Disorders (NIDCD)

University Health Network, Toronto

Participants experiencing any discomfort during or after participating in data collection were asked to report these to the study team. These were then reviewed for relatedness and seriousness.

Adult participants who have completed radiation therapy for oropharyngeal cancer within the past 3 months will undergo a swallowing x-ray study in which they will swallow liquid stimuli prepared to different consistencies.

Adults With Oropharyngeal Cancer

Adult participants who have completed radiation therapy for oropharyngeal cancer within the past 3 months.

Age, Continuous

Sex: Female, Male

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Canada

Region of Enrollment

Director, Swallowing Rehabilitation Research Laboratory

Participants were asked to take a series of 3 comfortable sips of thin liquid barium prepared in 20% w/v concentration using Bracco E-Z-Paque barium powder and water.

Thin Liquid Barium

Participants were asked to take a series of 3 comfortable sips of slightly thick liquid barium prepared in 20% w/v concentration using Bracco E-Z-Paque barium powder, water and Nestle Resource ThickenUp Clear thickener.

Slightly Thick Liquid Barium

Participants were asked to take a series of 3 comfortable sips of mildly thick liquid barium prepared in 20% w/v concentration using Bracco E-Z-Paque barium powder, water and Nestle Resource ThickenUp Clear thickener.

Mildly Thick Liquid Barium

Adult participants who had completed radiation therapy for oropharyngeal cancer within the past 3 months. A sample of 12 adults was enrolled. The thickened consistencies were only administered (and analyzed) for the 6 participants who displayed obvious unsafe swallowing on the thin liquid stimuli during data collection. A further 3 participants were determined to have shown unsafe swallowing on thin liquids during post-hoc analysis, but this was not recognized at the time of data collection.

Number of Participants With Unsafe Swallowing

Adult participants who had completed radiation therapy for oropharyngeal cancer within the past 3 months. A sample of 12 adults was enrolled. The thickened consistencies were only administered (and analyzed) for the 6 participants who displayed unsafe swallowing on the thin liquid stimuli.

Amount of Residue in the Pharynx

Lemon flavored water mixed with Nestle Resource ThickenUp clear thickener to a slightly thick consistency.

Slightly Thick Lemon Flavored Water

Bracco E-Z-Paque barium prepared in 20% w/v concentration and mixed with water and Nestle Resource ThickenUp Clear thickener to a slightly thick consistency.

Lemon flavored water mixed with Nestle Resource ThickenUp clear thickener to a mildly thick consistency.

Mildly Thick Lemon Flavored Water

Bracco E-Z-Paque barium prepared in 20% w/v concentration and mixed with water and Nestle Resource ThickenUp Clear thickener to a mildly thick consistency.

Lemon flavored water mixed with Nestle Resource ThickenUp clear thickener to a moderately thick consistency.

Moderately Thick Lemon Flavored Water

Adult participants who had completed radiation therapy for oropharyngeal cancer within the past 3 months. A sample of 12 participants was enrolled. However, only 7 participants completed the palatability testing component of the study.

Number of Participants Reporting Dislike of Thickened Liquid Stimuli

Adult participants who had completed radiation therapy for oropharyngeal cancer within the past 3 months who underwent a swallowing x-ray study in which they swallowed liquid stimuli prepared to different consistencies.

Overall Study

Trismus

Patients use the password-protected Project Prepare website on a computer, tablet, or phone over 10 weeks to view: videos of the swallowing and trismus exercises, tips and stories from former patients, what to expect each week of treatment, recipes and cooking demonstrations, how to take care of their teeth during treatment, strategies for stress relief, and strategies for dry mouth and nausea. This website is designed to reach underserved populations who do not have ready access to specialized preventive care.

Internet-Based Intervention

Quality-of-Life Assessment

Questionnaire Administration

Eileen H Shinn

Katrina M. Jensen

Eileen H. Shinn

This phase II trial studies how well a web-based program called Project Prepare works in helping patients with head and neck cancer adhere to swallowing and trismus exercises and coping strategies. Head and neck cancer patients who receive radiation therapy are at risk for permanent swallowing disorders and other side effects. Because of these potential problems, swallowing exercises and coping strategies are important parts of recovery. A web-based program designed to increase adherence to preventive exercises may help patients with head and neck cancer ameliorate the long-term effects of radiation therapy.

PRIMARY OBJECTIVE:

I. To determine the impact of a web-based adherence program (PREPARE) on self-reported swallowing function in head and neck cancer patients during radiation.

SECONDARY OBJECTIVE:

I. To determine community participant adherence to targeted swallowing and trismus exercises delivered by the PREPARE website video demonstrations.

EXPLORATORY OBJECTIVE:

I. To promote the long-term dissemination of the Dysphagia Prevention program through measurement of patient satisfaction and engagement metrics, training and continual feedback between the MD Anderson Cancer Center (MDACC) research site and community collaborative research sites.

OUTLINE:

Patients use the password-protected Project Prepare website on a computer, tablet, or phone over 10 weeks to view: videos of the swallowing and trismus exercises, tips and stories from former patients, what to expect each week of treatment, recipes and cooking demonstrations, how to take care of their teeth during treatment, strategies for stress relief, and strategies for dry mouth and nausea. This website is designed to reach underserved populations who do not have ready access to specialized preventive care.

After completion of study, patients are followed up at 6 months.

Web-Based Program in Helping Patients With Head and Neck Cancer Adhere to Swallowing Exercises and Coping Strategies

Mobile Delivery of a Coping and Adherence Program for Head and Neck Cancer Patients Being Treated in Community Care Settings

Assessed with the MD Anderson Dysphagia Inventory (MDADI). Will first test for changes in self-reported swallowing function outcome with the MDADI between baseline and follow-up using one-tailed paired t-tests. Correlations and multivariate analyses regressing self-reported adherence to exercises against self-reported swallowing function will be analyzed similarly and appropriately.

Piwik analytics will be used to record usage data regarding patient engagement with the website (e.g. whether the patient looked at the website that week, number of minutes and number of navigations and pages visited).

National Cancer Institute (NCI)

M.D. Anderson Cancer Center

Respiratory Aspiration

Chronically dysphagic, medically stable patients at least 6 months post treatment for head and neck cancer with non-optimal respiratory-swallowing patterns participated in up to 8 sessions of respiratory phase training to learn an optimal respiratory - swallow phase pattern

Patients were presented with visually guided respiratory feedback to train optimal respiratory-swallow coordination patterns.

Respiratory-Swallow Phase training

Bonnie J Martin-Harris

Cancers of the head and neck require surgical, radiation, and chemotherapy treatments that are intended to cure the disease. These treatments have toxic effects on muscles and structures that are necessary to swallow safely and efficiently. The resulting swallowing problems (dysphagia) often remain chronic for Veterans and interfere with their ability to eat and drink. The cost burden to the VA health system is high. There is an urgent need to develop rehabilitative treatments that lessen these burdens. The proposed research is designed to test a novel swallowing therapy that includes the coordination of breathing with swallowing. Our study will train medically and surgically treated, chronically dysphagic Veterans with histories of oropharyngeal cancer in a novel therapy that involves both swallowing and respiratory systems. If the therapy is found to be effective, the long term goal of the project is to extend the study to a multi-site, clinical trial and test the longstanding effect of this treatment compared to other swallowing therapies on swallowing function, QOL and cost.

Swallowing impairments (dysphagia) represent the highest functional morbidity in veteran patients treated for oropharyngeal cancers with either surgical approaches followed by radiation or with more recent organ-preservation protocols. The nature of the impairments is often resistive to treatment and results in life-long health consequences and high cost burden on the VA health system. Recent preliminary data have linked alterations in the otherwise highly stable respiratory-swallowing phase pattern relationships to the swallowing impairment and penetration/aspiration and in this patient group. The immediate goal of this clinical trial is to test the effect of a novel respiratory-swallow intervention on swallowing impairment and penetration/aspiration in a cohort of chronically dysphagic veterans 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 swallowing function in the acute phases of recovery and improve long term patient outcome. Our intention is to use these preliminary data to motivate a larger clinical trial to compare the effect of respiratory-swallow phase training with other evidenced based methods of swallowing treatment and expand the approach to other patient groups that have indications of respiratory-swallow phase impairments (e.g. pulmonary disease and stroke) contributing to impaired swallowing function

Respiratory-Swallow Training in Veterans With Oropharyngeal Cancer

Respiratory swallow patterns were collected using nasal airflow and respiratory inductance plethysmography (RIP) of each swallow during the modified barium swallow study. The movements of the ribcage and abdomen were recorded using RIP; data synchronized and recorded using the KayPentax Digital Swallow Workstation Signals Lab. Subjects were categorized as optimal (expiratory-expiratory) versus non-optimal (non-expiratory-expiratory).

Analysis of the percentage of impaired swallow components using a dichotomized MBSImP scoring system

The penetration aspiration scale is a validated 8 point interval scale used to describe penetration and aspiration events. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled. Scores \< 3 are considered to be normal. For the purpose of our study scores were dichotimized to normal and impaired.

US Department of Veterans Affairs

Patient completed daily EXACT-PRO questionnaires regarding respiratory symptoms. Reported changes were reviewed by pulmonologist

Chronically dysphagic, medically stable patients at least 6 months post treatment for head and neck cancer with non-optimal respiratory-swallowing patterns

Respiratory-Swallow Phase training: Will present patients with visually guided, respiratory feedback and train optimal respiratory-swallow coordination patterns, thereby providing the airway protection and mechanical benefits that have been observed in healthy individuals.

Arm 1

Respiratory-Swallow Phase Training

Age, Categorical

United States

Dr. Bonnie Martin Harris

Lip closure

Tongue control

Bolus transport

Oral residue

Initiation of pharyngeal swallow

Soft palate elevation

laryngeal elevation

Anterior hyiod excursion

Epiglottic inversion

Laryngeal vestibular closure

Pharyngeal stripping wave

Pharyngoesophageal segment opening

Tongue base retraction

Pharyngeal residue

Pre-intervention

Subjects that completed treatment were assessed within one week of meeting respiratory-swallow phase training goals

One Week Post Intervention

VAMC participants were assessed at one month following completion of the treatment protocol

One Month Post Intervention

Percentage of Impairment According to the Modified Barium Swallow Impairment Profile (MBSImP)

Percentage of Impairment According to the Penetration-Aspiration Scale

One Week Post-intervention

VAMC participants were reassessed at one month post treatment

Optimal Respiratory - Swallow Phase

Chronically dysphagic, medically stable patients at least 6 months post treatment for head and neck cancer with non-optimal respiratory-swallowing patterns

Respiratory - Swallow Phase Training

Heart and Blood Diseases

Stroke

A Vibrotactile stimulation device will be evaluated in patients with chronic moderate to severe dysphagia for more than 6 months post onset due to stroke or following radiation treatment for head and neck cancer to assess which frequency, mode, pressure characteristics are most helpful in increasing the rate of swallowing, increasing the urge to swallow, assisting with the initiation of swallowing and not affecting discomfort.

Comparison of the effects of different vibratory characteristics on the frequency of swallowing, time of initiation of swallowing with stimulation and urge to swallow. Will compare frequency of vibration, mode of vibration, pressure of device against neck, and duration of vibration. Each session will last no more than 1 hour with short breaks. Each participant can volunteer for up to three nonconsecutive sessions.

Vibrotactile stimulation

Christy L Ludlow, PhD

This is a device evaluation study to determine the optimal stimulation characteristics for using vibrotactile stimulation as a sensory triggering device for self retraining in patients with chronic moderate to severe dysphagia. Stimulation characteristics to be tested are frequency of vibration, pressure between the device and the skin, mode of vibration (pulsed or continuous).

Participants were recruited who had chronic moderate to severe dysphagia following stroke or radiation treatment for head and neck cancer. Their frequency of swallowing was transduced with an accelerometer placed on the skin over the thyroid cartilage and inductive plethysmography bands placed over the rib cage and abdomen. When laryngeal elevation coincided with respiratory apnea a swallow was marked. Five different motor frequencies were evaluated to determine their effect on participants frequency of swallowing (swallows per minute). Frequencies were 30, 70, 110, and 150 Hz and a combination of 70 and 110 Hz. For each vibratory frequency the number of swallows per minute occurring during stimulation was compared with sham when the participant was wearing the device but the motor was not turned on. The frequency fo swallowing during stimulation was compared with the frequency of swallowing between stimulations. Visual analogue ratings of the urge to swallow and discomfort were also measured after each condition. Other parameters were the pressure between the motor and the skin (0, 2, 4, and 6 kPa) and swallow initiation time when stimulation was on and when it was not. Swallowing frequency with continuous versus pulsed stimulation was also compared.

The Passy Muir Swallowing Self Training Device

Passy-Muir Swallowing Self Training Device to Enhance Recovery Post Stroke

Change in number of swallows per minute during stimulation minus swallows per minute during sham (wearing the device but no stimulation)

At the end of each stimulation session participants marked on a visual analogue scale (VAS) their perceived urge to swallow between a minimum of 1 with no urge to swallow and a maximum of 100 which is the highest urge to swallow possible. The Change in perceived urge to swallow when stimulation was presented minus the perceived urge to swallow following no stimulation was computed.

At the end of each stimulation session participants marked on a visual analogue scale (VAS) their perceived discomfort between a minimum of 1 with no discomfort and a maximum of 100 which is the highest discomfort possible. The Change in perceived discomfort when stimulation was presented minus the perceived discomfort following no stimulation was computed.

The pressure between the neck band and the skin was set and the changes in swallowing frequency was compared between pressure between increased pressure and no pressure condition

The pressure between the neck band and the skin was set and the changes in swallowing frequency was compared between increased pressure and no pressure condition

Percent Change= \[(Number of swallows per minute from continuous stimulation -number of swallows per minute during pulsed stimulation) / number of swallows per minute during pulsed stimulation\] X 100

Change in swallow initiation time (ms) from swallow reaction time during vibrotactile stimulation minus reaction time with sham (no) stimulation

Passy Muir Inc.

James Madison University

Professor

Vibrotactile stimulation: Comparison of the effects of different vibratory characteristics on the frequency of swallowing, time of initiation of swallowing with stimulation and urge to swallow. Will compare frequency of vibration, mode of vibration, pressure of device against neck, and duration of vibration. Each session will last no more than 1 hour with short breaks. Each participant can volunteer for up to three nonconsecutive sessions.

Vibrotactile Stimulation in Dysphagia

A Vibrotactile stimulation device will be evaluated in patients with chronic moderate to severe dysphagia for more than 6 months post onset due to stroke or following radiation treatment for head and neck cancer to assess which frequency, mode, pressure characteristics are most helpful in increasing the rate of swallowing, increasing the urge to swallow, assisting with the initiation of swallowing and not affecting discomfort

Vibrotactile stimulation: Comparison of the effects of different vibratory characteristics on the frequency of swallowing, time of initiation of swallowing with stimulation and urge to swallow. Will compare frequency of vibration, mode of vibration, pressure of device against neck, and duration of vibration. Each session will last no more than 1 hour with short breaks. Each participant can volunteer for up to three nonconsecutive sessions.

One of the 13 participants who was consented did not qualify and could not participate. The remaining 12 had severe chronic dysphagia unable to take nourishment by mouth. One of the 12 , 1 was not able to travel for the 2nd or 3rd visit and therefore only partial data are available on the 12 participants.

Recruitment was lower than anticipated, we were only able to recruit 12 participants rather than the 15 needed Participants found it burdensome to travel to the testing facility when there was no possible benefit to them for participation

Christy Ludlow

Change in Swallow Frequency 30 Hz

Change in Swallow Frequency 70 Hz

Change in Swallow Frequency 110 Hz

Change in Swallow Frequency 150 Hz

Change in Swallowing Frequency 70 & 110 Hz

Change in Urge to Swallow After 30 Hz Stimulation

Change in Urge to Swallow 70 Hz

Change in VAS Urge to Swallow 110 Hz

Change in VAS Urge to Swallow 150 Hz

Change in VAS Urge to Swallow 70 & 110 Hz

Vibrotactile stimulation: Comparison of the effects of different vibratory characteristics on the frequency of swallowing, time of initiation of swallowing with stimulation and urge to swallow and discomfort. Will compare frequency of vibration, mode of vibration, pressure of device against neck, and duration of vibration. Each session will last no more than 1 hour with short breaks. Each participant can volunteer for up to three nonconsecutive sessions.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Swallowing Pattern of Patients With Nasopharyngeal Cancer Before and After Radiation Therapy: Longitudinal Study and Correction With Saliva Amount	NCT00173836	Nasopharyngeal ...		20 Years -	National Taiwan University Hospital
Swallowing Pattern of Patients With Nasopharyngeal Cancer Before and After Radiation Therapy: Longitudinal Study and Correction With Saliva Amount	NCT00173836	Nasopharyngeal ...		20 Years -	National Taiwan University Hospital
Ultrasound Evaluation of Tongue Movements in Speech and Swallowing	NCT00001167	Otorhinolaryngo... Otorhinolaryngo... Pharyngeal Neop... Polymyositis Speech Disorder		-	National Institutes of Health Clinical Center (CC)
Physiological Flow of Liquids in Head and Neck Cancer Patients: A Pilot Study	NCT04112940	Deglutition Dis... Oropharynx Canc...	Starch-based Th... Xanthan-gum Thi...	18 Years - 100 Years	University Health Network, Toronto
Web-Based Program in Helping Patients With Head and Neck Cancer Adhere to Swallowing Exercises and Coping Strategies	NCT04003051	Throat Carcinom...	Internet-Based ... Quality-of-Life... Questionnaire A...	18 Years -	M.D. Anderson Cancer Center
Respiratory-Swallow Training in Veterans With Oropharyngeal Cancer	NCT01032928	Oropharyngeal D... Oropharyngeal C...	Respiratory-Swa...	21 Years -	VA Office of Research and Development
The Passy Muir Swallowing Self Training Device	NCT01765673	Oropharyngeal D...	Vibrotactile st...	20 Years -	James Madison University
Physiological Flow of Liquids in Head and Neck Cancer Patients: A Pilot Study	NCT04112940	Deglutition Dis... Oropharynx Canc...	Starch-based Th... Xanthan-gum Thi...	18 Years - 100 Years	University Health Network, Toronto

Spots Global Cancer Trial Database for swallowing

Every month we try and update this database with for swallowing cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for swallowing

Every month we try and update this database with for swallowing cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for swallowing cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.