Difficulty in swallowing (dysphagia) is caused by neurological impairment. It can happen because of several conditions, including stroke, traumatic brain injury, disorders of cerebral development, neurodegenerative diseases, major head and neck surgery (for example, to remove cancer), trauma and intensive care treatment (intubation and tracheostomy). Dysphagia may lead to malnutrition, dehydration, aspiration pneumonia and death.
Treatment options depend on the cause and severity of the dysphagia. Compensatory strategies include modifying diet (including thicker fluids and foods) and in moderate or severe dysphagia, nasogastric tubes, percutaneous endoscopic gastrostomy tubes or jejunostomy tubes may be used to provide nutritional support. Rehabilitation strategies include swallowing therapy (to help relearn swallowing and strengthen muscles) and for some people, transcutaneous neuromuscular stimulation.
A catheter with 2 electrodes on the outside is passed through the nose into the pharynx. Guide marks on the catheter are used to ensure it is correctly positioned to deliver low-level pharyngeal electrical stimulation. The catheter is connected to a portable base station, which stores the person's information and adjusts the stimulation variables. The exact stimulation level is calculated for each person at the start of each treatment session. Treatment is given by a healthcare professional with appropriate training and typically a treatment cycle consists of 10 minutes of stimulation each day for 3 consecutive days, for up to 2 cycles. People may experience a fizzing or tingling sensation in the throat during the procedure. The focused stimulation aims to increase brain activity in the swallowing control centre and restore neurological control of the swallowing function. The dual function catheter can also be used to administer enteral nutrition and fluids, if needed, as well as delivering electrical stimulation.