title: Electrical pharyngeal stimulation for dysphagia treatment in tracheotomized stroke patients: a randomized controlled trial.
abstract: OBJECTIVE
  Treatment of post-stroke dysphagia is notoriously difficult with different neurostimulation strategies having been employed with a variable degree of success. Recently, electrical pharyngeal stimulation (EPS) has been shown to improve swallowing function and in particular decrease airway aspiration in acute stroke. We performed a randomized controlled trial to assess EPS effectiveness on swallowing function in severely dysphagic tracheotomized patients.
  
  
  METHODS
  All consecutive stroke patients successfully weaned from the respirator but with severe dysphagia precluding decannulation were screened for eligibility. Eligible patients were randomized to receive either EPS (N = 20) or sham stimulation (N = 10) over three consecutive days. Primary endpoint was ability to decannulate the patient. Swallowing function was assessed using fiberoptic endoscopy. Patients having received sham stimulation were offered EPS treatment during unblinded follow-up if required. Investigators were blinded to the patient's study group allocation.
  
  
  RESULTS
  Both groups were well matched for age, stroke severity, and lesion location. Decannulation after study intervention was possible in 75% of patients of the treatment group and in 20% of patients of the sham group (p < 0.01). Secondary outcome parameters did not differ. No adverse events occurred.
  
  
  CONCLUSIONS
  In this pilot study, EPS enhanced remission of dysphagia as assessed with fiberoptic endoscopic evaluation of swallowing (FEES), thereby enabling decannulation in 75% of patients.
authors.affiliation: Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany, sonjasuntrup@uni-muenster.de.
authors.forename: Sonja
authors.initials: S
authors.lastname: Suntrup
authors.forename: Thomas
authors.initials: T
authors.lastname: Marian
authors.forename: Jens Burchard
authors.initials: JB
authors.lastname: Schröder
authors.forename: Inga
authors.initials: I
authors.lastname: Suttrup
authors.forename: Paul
authors.initials: P
authors.lastname: Muhle
authors.forename: Stephan
authors.initials: S
authors.lastname: Oelenberg
authors.forename: Christina
authors.initials: C
authors.lastname: Hamacher
authors.forename: Jens
authors.initials: J
authors.lastname: Minnerup
authors.forename: Tobias
authors.initials: T
authors.lastname: Warnecke
authors.forename: Rainer
authors.initials: R
authors.lastname: Dziewas
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology* / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010614:Pharynx; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications*; D014140:Tracheotomy