This service is for adults with complex or persistent swallowing difficulties, including structural and mechanical problems. It includes specialist assessment and individualised therapy, and second-opinion consultations for patients and families who would like another professional view of their swallowing assessment and management plan. We also offer swallowing preservation programmes for patients undergoing or recovering from radiotherapy for Nasopharyngeal Carcinoma (NPC) and head and neck cancers.
sEMG biofeedback lets patients see their swallowing muscle activity on a screen while they exercise, to help retrain muscle coordination. Therapy plans are individualised and staged, with the aim of improving swallowing safety and, where appropriate, working towards a gradual return to eating by mouth for patients on tube feeding.
Conditions that often cause complex swallowing difficulties
- Multiple strokes, or neurodegenerative conditions such as multiple system atrophy and multiple sclerosis
- Brainstem stroke (e.g. lateral medullary syndrome)
- Head and neck cancer, especially after surgery
- Late effects of radiotherapy to the head and neck
- Head and neck injury, e.g. after a road traffic accident
Treating complex swallowing difficulties takes more than exercises. It needs careful clinical reasoning and close teamwork with doctors and other healthcare professionals.
What a second opinion can cover
- The likely cause of the swallowing difficulty and its outlook for recovery
- Feeding options: eating by mouth, tube feeding, or a combination
- Whether an instrumental assessment (FEES or videofluoroscopy) would help
- Therapy options, such as targeted swallowing exercises, sEMG biofeedback, electrical stimulation or K-taping
- Referral to other medical specialists where needed