@gareee314 Sounds good that the exercise is helping and crossing fingers that this might help him too. They also removed all lymph nodes from his neck (all found to be ok with no cancer). His neck did swell in the front with fluid but seems to be going down. I've arranged for a lymphatic drainage massage this week and hope this helps. 4-1/2 years is very long and you certainly have a lot of patience, my fear also is the aspirating going to the lungs. . Husband has to carry kleenexes with him everywhere he goes in case he happens to drink something. Did they tell you about maybe trying a Palate Obturator? This seems to be the plan our surgeon mentioned to follow after 6 months but from what I've heard, even on this site, not very successful. We were disappointed to find out that he is not considering a surgical flap which was originally discussed prior to surgery and supposed to correct the aspiration and nasal speech. Thank you for confirming that the swallow/speech might help. Wishing you a magical and speedy recovery!