ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
MfMRI assessment of muscle activation by swallowing exercises in laryngectomized individuals: investigating conventional and resistance-based exercises using the swallow exercise aid (SEA).
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Management of dysphagia in head and neck cancer: current and future perspectives.Frontiers in oncology · 2026Review
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Abstract
purposeAfter total laryngectomy, dysphagia is common due to changes in anatomy and physiology. Currently, it is unclear if the remaining muscles still can be activated with swallowing exercises. This study aims to assess which muscles, if any, are activated after conventional or resistance-based exercises with the Swallowing Exercise Aid (SEA) using mfMRI-based T2maps.
methodsFive laryngectomized individuals underwent mfMRI before and after six exercises. Three conventional (Effortful Swallow, Masako, Shaker) and three SEA exercises (Chin Tuck, Jaw Opening and Effortful Swallow Against Resistance (CTAR, JOAR and ESAR, resp.)) were assessed. T2 mapping scans were made pre and post all exercises carried out until exhaustion. Muscles of interest were the medial and lateral pterygoids, intrinsic and extrinsic tongue, suprahyoid, superior pharyngeal constrictor, masseter and sternocleidomastoid muscles. Primary parameter was the difference (Δ) of the post- and pre-exercise T2 map values in milliseconds.
resultsIn total, 1.490 annotated muscles were analyzed. Following the swallowing exercises, true positive Δ T2 map values were found in up to 90% of these muscles. Each exercise (conventional and SEA-based) activated at least three muscles of interest, in varying numbers per exercise. Among all annotated muscles, percentages of positive Δ T2 map values were highest for the lateral pterygoid muscles following the SEA exercises CTAR and JOAR (70 and 90%, resp.).
conclusionThis mfMRI study shows that after total laryngectomy swallowing muscles still can be activated with swallowing exercises. The SEA-based exercises CTAR and JOAR showed the highest percentage of bilateral activation.
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