Can VocaSTIM® Therapy Reverse Swallowing Difficulties After NPC Treatment?

Dysphagia

Hello Dr.
Lee: My father underwent radiotherapy for nasopharyngeal carcinoma seven years ago.
In recent years, he has experienced neck stiffness, dry mouth, and difficulty swallowing.
He can only eat softer foods like rice and skin from meat; other ingredients need to be processed with a blender, and liquids must be thickened to be consumed.
Recently, he was diagnosed with pneumonia, and the chest physician recommended a gastrostomy.
However, since he is quite heavy, I would like to ask if the vocaSTIM® voice and swallowing training therapy can reverse the condition for such patients?

Liu Xiaojie, 30~39 year old female. Ask Date: 2022/05/03

Dr. Li Yanheng reply Rehabilitation

In cases where swallowing difficulties are suspected to be caused by cervical muscle fibrosis, the effectiveness of swallowing therapy devices may be limited.
It is recommended to seek evaluation at a rehabilitation department or an otolaryngology swallowing clinic.

Reply Date: 2022/05/03

More Info

VocaSTIM® Therapy is a specialized treatment designed to address swallowing difficulties, particularly in patients who have undergone treatments for head and neck cancers, such as nasopharyngeal carcinoma (NPC). After radiation therapy (RT), many patients experience complications like stiffness in the neck, dry mouth, and dysphagia (difficulty swallowing), which can significantly impact their quality of life.

In your father's case, having undergone RT for NPC seven years ago, it is not uncommon for him to experience these symptoms. The radiation can lead to changes in the anatomy and function of the swallowing mechanism, resulting in the need for modified diets and thickened liquids, as you've described. VocaSTIM® Therapy utilizes electrical stimulation to activate the muscles involved in swallowing, potentially improving muscle strength and coordination. This therapy aims to enhance the swallowing reflex and may help patients regain some ability to swallow more effectively.

While VocaSTIM® Therapy has shown promise in clinical settings, its effectiveness can vary from patient to patient. Factors such as the extent of the damage caused by radiation, the duration of swallowing difficulties, and the overall health of the patient play crucial roles in determining the outcome. In some cases, patients have reported improvements in their swallowing abilities, allowing them to consume a wider variety of foods and liquids without the need for extensive modifications.

It is essential to have a thorough evaluation by a speech-language pathologist (SLP) who specializes in dysphagia management. They can assess your father's swallowing function and determine if he is a suitable candidate for VocaSTIM® Therapy. Additionally, they can provide a tailored rehabilitation program that may include exercises to strengthen the swallowing muscles, dietary modifications, and strategies to manage symptoms effectively.

If your father is experiencing significant swallowing difficulties and is at risk of aspiration (food or liquid entering the airway), it is crucial to address these issues promptly. While a gastrostomy (feeding tube) may be considered if oral intake becomes unsafe or insufficient, exploring therapies like VocaSTIM® could provide an alternative or complementary approach to improve swallowing function.

In summary, VocaSTIM® Therapy has the potential to help reverse swallowing difficulties after NPC treatment, but its success will depend on individual circumstances. Consulting with a qualified SLP and discussing all available options, including VocaSTIM®, will be vital in determining the best course of action for your father's swallowing difficulties.

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