Clinical Impact of Respiratory-Swallow Training on Refractory Dysphagia in Oropharyngeal Head and Neck Cancer

Inclusion Criteria: * Veteran and non Veterans * have undergone treatment for a primary diagnosis of head and neck cancer (oral cavity, oropharyngeal, and hypopharyngeal) * are 21 years of age * 6 months post head and neck cancer treatment * 6 months post-traditional swallowing treatment with continued dysphagia * English speaking * pass a cognitive screening (score 26 on the Montreal Cognitive Assessment (MoCA) * do not present with severe chronic obstructive pulmonary disease (COPD) based on pulmonary function testing (PFT) * drink less than 2 alcoholic beverages per day Exclusion Criteria: * if they have known allergy or dietary restriction for contrast materials or liquids used during the MBSS or training * currently drinking greater than two drinks per day * severe COPD * are unable to swallow one liquid consistency without the use of a compensatory strategy or swallow maneuver without aspiration * history of aspiration pneumonia within the past 12 months