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Comparison of Two Therapies for UES Dysphagia

21 Years
90 Years
Not Enrolling
Deglutition Disorders

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Trial Information

Comparison of Two Therapies for UES Dysphagia

Secondary aims of this research are:

1. Determine in a descriptive manner whether patients with residue in the pyriform sinuses
who aspirate the residue after the swallow respond better, i.e., a higher percentage of
them can return to 100% oral intake, than patients with residue in the valleculae who
aspirate after the swallow or patients with residue in both locations who aspirate
after the swallow and thus to define the spectrum of indications for the proposed
exercise programs in the two groups of dysphagic patients (stroke and post-chemo
radiation treatment for head and neck cancer) and whether postures enable each patient
type to swallow more bolus types without aspiration at pre- and post

2. Define the pathophysiology underlying the swallow dysfunction and those
pathophysiologic elements which change as a result of each therapy program including
changes in -

1. anteroposterior and lateral diameter of maximum deglutitive UES opening

2. maximum deglutitive laryngeal anterior and superior excursions

Inclusion Criteria

Inclusion Criteria (all required)

- Patients with pharyngeal phase dysphagia due to stroke or chemoradiation for head and
neck cancer (without surgical intervention)

- Incomplete UES opening and post-deglutitive aspiration

- Hypopharyngeal (pyriform sinus) residue or vallecular residue alone or in combination

- Dysphagia requiring tube feeding (at least 3 months non-oral condition)

- Able to comply with protocol mandates, willing to perform the exercise programs, and
ability to attend study sessions.

Exclusion Criteria

- Pharyngeal surgical procedures

- Other neuromuscular disorders such as

- Lack of cognition

- Metabolic myopathies

- History of alcoholic neuropathy

- Steroid myopathy

- Cervical spine injury, lesions, or large osteophytes

- Kerns-Sayers Syndrome

- Individuals unable to exercise independently

- Oculo-pharyngeal and other dystrophies

- Current use of anticholinergics:

bensodiazopin, antihistamines

- Myasthenia gravis

- Elimination of aspiration with posture during VFG

- Absent pharyngeal swallow on VFG

- Aspiration before or during the swallow (pre and intradeglutitive aspiration)

- Not completely tube feeding dependent

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Primary Purpose: Treatment

Principal Investigator

Reza Shaker, M.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

Professor and Chief, Division of Gastroenterology and Hepatology, Director, Digestive Disease Center, Medical College of Wisconsin


United States: Federal Government

Study ID:

UESD (completed)



Start Date:

Completion Date:

December 2007

Related Keywords:

  • Deglutition Disorders
  • UES
  • Dysphagia
  • Deglutition Disorders



Medical College University of Wisconsin Milwaukee, Wisconsin