title: Neuromuscular Electrical Stimulation for Treatment-Refractory Chronic Dysphagia in Tube-Fed Patients: A Prospective Case Series.
abstract: The aim of this study was to evaluate the role of neuromuscular electrical stimulation (NMES) in tube-fed patients with severe and chronic dysphagia refractory to traditional swallowing therapy (TT).
  
  
  
  A total of 11 consecutive dysphagic patients with tube-dependent nutrition and who had not responded to 6 months of TT were enrolled. Each patient received NMES for 30 min and TT for 30 min, twice a day, 5 days per week for 4 weeks. In order to evaluate the swallowing impairment, each patient underwent a fiberoptic endoscopic examination of swallowing immediately before the beginning of the treatment, after 2 weeks and after 4 weeks.
  
  
  
  All enrolled patients managed to complete the swallowing treatment protocol for at least 2 weeks. After the 4-week treatment, 6 of 11 enrolled patients passed to a total oral diet with single or multiple consistencies despite specific food limitations or special preparation or compensation. Five patients, all affected by the most severe form of dysphagia, maintained tube-dependent nutrition.
  
  
  
  NMES as adjunctive treatment to TT may offer a new possibility for the management of tube-fed patients who are refractory to TT.
authors.affiliation: Phoniatric Unit, Department of Biomedical and Clinical Sciences x2018;L. Sacco', University of Milan, Milan, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Scarponi
authors.forename: Francesco
authors.initials: F
authors.lastname: Mozzanica
authors.forename: Valeria
authors.initials: V
authors.lastname: De Cristofaro
authors.forename: Daniela
authors.initials: D
authors.lastname: Ginocchio
authors.forename: Nicole
authors.initials: N
authors.lastname: Pizzorni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bottero
authors.forename: Antonio
authors.initials: A
authors.lastname: Schindler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D004599:Electric Stimulation Therapy; D004724:Endoscopy; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009469:Neuromuscular Junction / Q000503:physiopathology*