Remediation challenges in treating dysphagia post head/neck cancer. A problem-oriented approach.

A problem-oriented approach to dysphagia treatment was developed for a post head/neck surgery patient with a hematologic condition. Treatment was graded so that a hierarchical approach was used for all problems. Passive and resistive exercises preceded active exercise, and sensory stimulation preceded motion tasks. After 3 mo of treatment using an oral sensory motor stimulation paradigm and graded series of lip and tongue strengthening and motion exercises, swallowing had improved so that total nutritional intake was by mouth and weight was restored to normal. He was able to resume an active social life and to engage in vocational activities and hobbies.