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Objective To investigate the therapeutic effect of electroacupuncture at Lianquan point combined with transcranial direct current stimulation (tDCS) on elderly patients with swallowing disorder after stroke. Methods From July 2022 to November 2023, a total of 116 elderly patients with swallowing disorder after stroke admitted to Handan Central Hospital were divided into a control group and a study group according to random number table, each had 58 cases. The control group was treated with tDCS, and the a study group was treated with electroacupuncture at Lianquan point combined with tDCS. The total effective rate, swallowing difficulties ［modified Mann assessment of swallowing ability scale (MASA)］, nutritional indexes ［serum prealbumin (PA) and albumin (ALB)］, surface electromyography results (EMG swallowing duration and maximum amplitude), nerve injury indexes ［brain-derived neurotrophic factor (BDNF) and neuropeptide Y (NPY)］ and long-term prognostic indicators ［activities of daily living scale (ADL)］ were compared between the two groups. Results After treatment, the total effective rate and MASA score in the study group were higher than those in the control group; PA and ALB were higher than those in the control group, swallowing duration was shorter than that in the control group, and the maximum amplitude was larger than that in the control group. BDNF was higher than that in the control group, NPY was lower than that in the control group; the ADL score was higher than that in the control group, with statistical significance (P

Objective To investigate the effect of acupoint massage on swallowing function and quality of life in elderly patients with swallowing disorder after acute ischemic stroke(AIS). Methods A total of 64 AIS patients with swallowing disorder admitted to Jiangsu Province Hospital of TCM from December 2021 to June 2023 were selected as the study subjects. They were randomly divided into an observation group and a control group randomly, with 32 cases in each group. The control group was treated by routine therapeutic method, and the observation group was treated with acupoint massage on the basis of the control group. The treatment course of both groups was 4 weeks. The clinical efficacy, swallowing function ［standardized swallowing assessment (SSA) and vision fluorescence swallowing study (VFSS)］, oral feeding function ［functional oral intake scale (FOIS)］, quality of life ［Chinese version of swallowing-quality of life (SWAL-QOL)］ and complications before and after treatment were compared between the two groups. Results The total effective rate in the observation group was higher than that in the control group (P

Dysphagia is more common in conditions such as stroke, Parkinson's disease, and head and neck cancer. This can lead to pneumonia, choking, malnutrition, and dehydration. Currently, the diagnostic gold standard uses radiologic imaging, the videofluoroscopic swallow study (VFSS); however, it is expensive and necessitates specialized facilities and trained personnel. Although several devices attempt to address the limitations, none offer the clinical‐grade quality and accuracy of the VFSS. Here, this study reports a wireless multimodal wearable system with machine learning for automatic, accurate clinical assessment of swallowing behavior and diagnosis of silent aspirations from dysphagia patients. The device includes a kirigami‐structured electrode that suppresses changes in skin contact impedance caused by movements and a microphone with a gel layer that effectively blocks external noise for measuring high‐quality electromyograms and swallowing sounds. The deep learning algorithm offers the classification of swallowing patterns while diagnosing silent aspirations, with an accuracy of 89.47%. The demonstration with post‐stroke patients captures the system's significance in measuring multiple physiological signals in real‐time for detecting swallowing disorders, validated by comparing them with the VFSS. The multimodal electronics can ensure a promising future for dysphagia healthcare and rehabilitation therapy, providing an accurate, non‐invasive alternative for monitoring swallowing and aspiration events. [ABSTRACT FROM AUTHOR]

Abstract Multidisciplinary clinics bring together multiple specialists to care for patients with complex diseases, such as swallowing disorders. Little information exists regarding dysphagia in pediatric patients and its multidisciplinary management in Colombia. This study aimed to characterize patients under the age of 18 with swallowing disorders treated in a multidisciplinary dysphagia clinic at San Vicente Fundacion Hospital in Medellin, Colombia, between 2014 and 2021. A longitudinal, descriptive, observational study with retrospective data collection was conducted. Sociodemographic and clinical data were obtained at three points. A total of 293 patients were included. The most frequent underlying diseases were neurological (mainly cerebral palsy), followed by genetic disorders, with Down syndrome being the most representative. More than 50% of the patients had been hospitalized at least twice for dysphagia. The diagnosis was primarily clinical, supported by a videofluoroscopic swallowing study. The primary prescribed intervention was speech therapy, followed by an alternate feeding route. This study described pediatric patients with swallowing disorders seen in a multidisciplinary clinic. This overview provides healthcare personnel with an understanding of the complexity of swallowing disorders and their relationships to various medical conditions in children.

Objectives: Since December 2019, COVID-19 spread worldwide. Patients with COVID-19 are at high hazard for dysphagia. This study investigates the incidence of dysphagia in COVID-19 patients admitted to the intensive care unit (ICU) and identifies predictors of dysphagia in COVID-19 patients. Methods: This prospective study analyzed 100 COVID-19 patients admitted to the ICU of Firoozgar Hospital in Tehran City, Iran. The demographic and clinical features of the eligible patients were collected. Dysphagia and cognition were evaluated according to the Persian version of functional oral intake (FOIS-P) status and the Rancho Los Amigos scale (RLAS). The qualitative variables are described in frequency and percentages and the quantitative variables are illustrated by Mean±SD. Also, univariate and multivariate cox regression was performed to predict possible relations between demographic and clinical variables with dysphagia. Results: A total of 100 COVID-19 patients (43.3±13.3 years, 55% were men) who were admitted to the ICUs were appraised by speech and language pathologists. Meanwhile, 70% of the subjects had at least one comorbidity, with the most common ones being diabetes, hypertension, and obesity. Also, 74% of patients were on invasive mechanical ventilation (60% through endotracheal tube and 40% through tracheostomy). In addition, 57% of patients presented dysphagia. Age (odd ratio (OR)=1.127; 95% confidence interval (CI), 1.019%, 1.247%; P=0.02) and level of consciousness (OR=0.393; 95% CI, 0.178%, 0.868%; P=0.021) were predictors of dysphagia. Discussion: Dysphagia was prevalent among COVID-19 patients predicted by age and level of consciousness. Early evaluation of suspected patients is required for timely and efficient interventions to avoid further problematic issues and progress their quality of life.

Objective: Care of patients with dysphagia occurs at the intersection of several different medical specialties. Otolaryngologists are uniquely equipped to diagnose dysphagia given their specialized training, yet the extent to which otolaryngologists perform diagnostic procedures for dysphagia is unknown. The objective of this study was to characterize the specialty‐level variation among providers performing diagnostic assessments for dysphagia. Methods: We performed a retrospective, cross‐sectional analysis of dysphagia care utilization among Medicare beneficiaries from 2013 to 2021 using the CMS Physician & Other Practitioners by Provider and Service dataset. American Association of Medical Colleges (AAMC) data reports were used to determine the total number of providers per specialty. For each procedure and specialty, the percentage of providers performing >10 procedures annually and the average annual number of procedures per performing provider (non‐radiology) were calculated. Results: We analyzed nine common dysphagia diagnostic procedures, including manometry, 24‐h pH testing, flexible endoscopic evaluation of swallowing (FEES), and modified barium swallow study (MBSS). Mean 3.7 (SD 1.4) otolaryngologists (0.04% of practicing) performed manometry testing annually, compared to 493 (69.3) gastroenterologists (3.3%). Less than 1% of practicing otolaryngologists (37.8 (8.0) (0.04%)) and gastroenterologists (51.6 (8.4), 0.35%) performed 24‐h pH testing annually. FEES testing was most commonly performed by otolaryngologists; however, only 48 (6.3) providers (0.51% of practicing) performed these procedures annually. For MBSS, fewer otolaryngologists (5.2 (1.0), 0.05%) perform these assessments than other medical specialties. Each otolaryngologist performed 110.7 (52.5) studies annually, compared to 200.1 (68.0) per gastroenterologist. Conclusion: Otolaryngologists represent a small fraction of providers performing dysphagia‐related diagnostic procedures despite a unique training within our specialty to comprehensively diagnose and manage this condition. Level of Evidence: 3 Laryngoscope, 134:3698–3705, 2024 [ABSTRACT FROM AUTHOR]

The safe ingestion of food and water requires appropriate coordination between the respiratory and swallowing pathways. This coordination can be disrupted because of aging or various diseases, thereby resulting in swallowing disorders. No comparative research has been conducted on methods for effectively screening swallowing disorders in individuals and providing timely alerts to their caregivers. Therefore, the present study developed a monitoring and alert system for swallowing disorders by using three types of noninvasive sensors, namely those measuring nasal airflow, surface electromyography signals, and thyroid cartilage movement. Two groups of participants, one comprising healthy individuals (58 participants; mean age 49.4 years) and another consisting of individuals with a history of unilateral stroke (21 participants; mean age 54.4 years), were monitored when they swallowed five volumes of water. Through an analysis of the data from both groups, seven indicators of swallowing disorders were identified, and the proposed system characterized the individual's swallowing state as having a green (safe), yellow (unsafe), or red (highly unsafe) status on the basis of these indicators. The results indicated that the symptoms of swallowing disorders are detectable. Healthcare professionals can then use these data to conduct assessments, perform screening, and provide nutrient intake suggestions. [ABSTRACT FROM AUTHOR]

Objectives: Since December 2019, COVID-19 spread worldwide. Patients with COVID-19 are at high hazard for dysphagia. This study investigates the incidence of dysphagia in COVID-19 patients admitted to the intensive care unit (ICU) and identifies predictors of dysphagia in COVID-19 patients. Methods: This prospective study analyzed 100 COVID-19 patients admitted to the ICU of Firoozgar Hospital in Tehran City, Iran. The demographic and clinical features of the eligible patients were collected. Dysphagia and cognition were evaluated according to the Persian version of functional oral intake (FOIS-P) status and the Rancho Los Amigos scale (RLAS). The qualitative variables are described in frequency and percentages and the quantitative variables are illustrated by Mean±SD. Also, univariate and multivariate cox regression was performed to predict possible relations between demographic and clinical variables with dysphagia. Results: A total of 100 COVID-19 patients (43.3±13.3 years, 55% were men) who were admitted to the ICUs were appraised by speech and language pathologists. Meanwhile, 70% of the subjects had at least one comorbidity, with the most common ones being diabetes, hypertension, and obesity. Also, 74% of patients were on invasive mechanical ventilation (60% through endotracheal tube and 40% through tracheostomy). In addition, 57% of patients presented dysphagia. Age (odd ratio (OR)=1.127; 95% confidence interval (CI), 1.019%, 1.247%; P=0.02) and level of consciousness (OR=0.393; 95% CI, 0.178%, 0.868%; P=0.021) were predictors of dysphagia. Discussion: Dysphagia was prevalent among COVID-19 patients predicted by age and level of consciousness. Early evaluation of suspected patients is required for timely and efficient interventions to avoid further problematic issues and progress their quality of life. [ABSTRACT FROM AUTHOR]

The article describes the case of a three-year-old boy with Coffin-Lowry syndrome (CLS) and was referred to the Swallowing Disorders Department. Topics discussed include clinical description of CLS, medical history of the patient, and results of clinical evaluation and videofluoroscopic swallow study. Also mentioned are serious complications that may be caused by swallowing disorders and benefits of home-based chewing and swallowing training (CST).

Background: The Pediatric Eating Assessment Tool (PEDI‐EAT‐10) is a reliable and valid tool for rapid identification of dysphagia in patients aged 18 months to 18 years. Aims: To translate and adapt the PEDI‐EAT‐10 into the Italian language and evaluate its validity and reliability. Methods & Procedures: The translation and cross‐cultural adaptation of the tool consisted of five stages: initial translation, synthesis of the translations, back translation, expert committee evaluation and test of the prefinal version. The internal consistency of the translated tool was analysed in a clinical group composed of 200 patients with special healthcare needs aged between 18 months and 18 years. They were consecutively enrolled at the Rare Disease Unit, Paediatrics Department, Fondazione Policlinico Agostino Gemelli‐IRCCS, Rome. For test–retest reliability, 50 caregivers filled in the PEDI‐EAT‐10 questionnaire for a second time after a 2‐week period. Construct validity was established by comparing data obtained from patients with data from healthy participants (n = 200). The study was approved by the local ethics committee. Outcomes & Results: Psychometric data obtained from patients (104 M; mean age = 8.08 ± 4.85 years; median age = 7 years) showed satisfactory internal consistency (Cronbach's α = 0.89) and test–retest reliability (Pearson r = 0.99; Spearman r = 0.96). A total of 30% of children were classified as having a high risk of penetration/aspiration. The Italian PEDI‐EAT‐10 mean total score of the clinical group was significantly different from that resulting from healthy participants. Conclusions & Implications: The PEDI‐EAT‐10 was successfully translated into Italian, validated and found to be a reliable one‐page rapid screening tool to identify dysphagia in children and adolescents with special needs. What this paper adds: What is already known on the subject: The PEDI‐EAT‐10 is a valid and reliable quick discriminative paediatric tool for identifying penetration/aspiration risks. What this paper adds to the existing knowledge: In the present study we successfully translated and adapted the PEDI‐EAT‐10 into the Italian language. What are the potential or actual clinical implications of this work?: This translation and adaptation increase access to valid feeding and swallowing assessment for children of Italian‐speaking families. In addition, the I‐PEDI‐EAT‐10 can suggest further assessment of patients' swallowing abilities. [ABSTRACT FROM AUTHOR]

Background Ageing process and abnormal protein accumulation in dementia damage neural pathways affecting the swallowing process and leading to swallowing disorder. Objective To estimate the prevalence of swallowing disorder among older adults with different dementia subtypes. Methods We conducted a systematic search across multiple databases, including PubMed, Embase, Scopus, Web of Science and OVID Medline. The meta-analysis employed R (version 4.0.2) and utilised a generalised linear mixed model with a random-effect approach to estimate the pooled prevalence of swallowing disorder among older adults, considering various dementia subtypes. The quality of included studies was assessed using Hoy's criteria. Heterogeneity was identified through Cochrane's Q and I 2 statistics. To further explore heterogeneity, moderator analysis was performed to identify the contributing variables among the included studies. Results Eighteen studies with 12,532 older adults with different dementia subtypes were enrolled in our meta-analysis. The pooled prevalence of swallowing disorder among older adults with dementia was 58%, with 46.5% for Alzheimer's dementia, 34.9% for Parkinson's dementia, 18.8% for vascular dementia, 16.3% for mixed dementia and 12.2% for Lewy body dementia. According to assessment tools, Alzheimer's dementia had the highest prevalence, with 58% in instrumental assessments and 39% in clinical assessments. Medical history, Alzheimer's dementia, moderate-to-severe Clinical Dementia Rating, delayed oral phase, delayed pharyngeal phase and poor tongue motility contributed to the heterogeneity of the included studies. Conclusions More than half of older adults with dementia demonstrate to have swallowing disorder. Our findings offer valuable insights to healthcare professionals for the identification of swallowing disorder in ageing population with dementia. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the swallowing status of patients with tongue cancer undergone tongue reconstruction using radial forearm free flaps (RFFF) and submental flaps were compared. Methods: A total of 26 patients with tongue cancer undergone tongue resection were randomly treated by tongue reconstruction with either submental flap or RFFF approach. Swallowing status of the patients was investigated using fiberoptic endoscopic evaluation of swallowing (FEES) by measurement of pharyngeal residue and penetration scales. Results: The pharyngeal residue scale in vallecula and pyriform sinus and the average of vallecula and pyriform sinus on days 10 and 30 post-operation as well as penetration scale at the same time showed no significant difference between two groups. However, the time to start oral feeding was significantly reduced in the submental group compared to the free flap group (P = 0.031). A positive Pearson correlation was found between the size of oral tongue and base of tongue resection and some of swallowing parameters. Conclusion: Since there was no significant difference between submental and free flap respected to swallowing disorder, the submental flap is prior to free flap due to lower cost and hospitalization and less complication after tongue reconstruction. [ABSTRACT FROM AUTHOR]

Objective Swallowing disorder or dysphagia is one of the most common problems in old age and after brain vascular lesions. This problem has received a lot of attention in studies. However, Pain on swallowing (known as odynophagia) has been less discussed in the literature. The present study aimed to investigate the existence of pain on swallowing, its characteristics, the possible intervention, and the effects of this pain on the quality of life of affected people. Materials & Methods The present study adopted a qualitative approach. After purposeful sampling, we interviewed 11 speech therapists in the field of swallowing disorders (5 males) and 15 patients with dysphagia. All the interviews were transcribed and underwent content analysis using the Graneheim and Lundman method. Finally, the main themes, subcategories, semantic units, and examples related to each were obtained. Results Out of 15 interviewed patients, only 6 reported pain on swallowing. In comparison, all 11 therapists in the field of swallowing disorders confirmed the presence of pain on swallowing. Seven main themes were obtained based on these interviews: The temporal pattern, duration, location, stimulating/provoking factors, type, intensity, and onset time. Each of these themes had its subcategories and items. All patients and therapists reported the negative impact of pain on swallowing on the quality of life. There was an agreement between therapists and patients to manage pain on swallowing. Conclusion This study showed that pain on swallowing is probably one of the characteristics of a swallowing disorder, and professionals must consider pain on swallowing during the clinical examination. Future studies can focus on different dimensions of pain on swallowing and develop proper evaluation scales.

Abstract Background Oropharyngeal dysphagia is highly prevalent among hospitalized geriatric patients. The screening instruments used to date have been evaluated primarily in stroke patients. This diagnostic study aimed to validate a new screening instrument for oropharyngeal dysphagia, the ‘Dysphagia Screening Tool for Geriatric Patients’ (DSTG), as compared to one of the gold standards, flexible endoscopic evaluation of swallowing (FEES). Materials and methods Geriatric inpatients admitted to five geriatric hospitals in Germany were consecutively evaluated using both DSTG and FEES in random order and by different evaluators blinded to the results of the other evaluation. In the FEES examination, a score of more than 3 on Rosenbek’s Penetration Aspiration Scale was considered evidence of clinically relevant oropharyngeal dysphagia. Sensitivity, specificity and further measures of test performance were calculated for DSTG. Results The 53 volunteers recruited were on average 85 years of age, 56.6% were women. Twenty patients (37.7%) were diagnosed with dysphagia using FEES. Of these, 12 were screened as positive on DSTG. Of the 33 FEES negative patients, 4 tested positive on DSTG. The following test parameters were calculated for DSTG: sensitivity: 0.60, 95% confidence interval [0.39 ; 0.78], specificity 0.88 [0.73 ; 0.95], positive predictive value 0.75 [0.51 ; 0.90], negative predictive value 0.78 [0.63 ; 0.89], positive likelihood ratio 4.95 [1.85 ; 13.27], negative likelihood ratio 0.46 [0.26 ; 0.79]. In a receiver-operator characteristic (ROC) curve analysis, the area under the curve (AUC) was 0.77 [0.62 ; 0.91]. No adverse events occurred. Conclusion The DSTG appears to be a valid instrument for screening of oropharyngeal dysphagia in geriatric inpatients.

Background: A swallowing disorder is one of the most common problems in the pediatric population. Schedule for Oral-Motor Assessment (SOMA) has become one of the best methods for the assessment of swallowing disorders in the pediatric population. In this study, we evaluated the sensitivity, specificity, and consistency of SOMA by fluoroscopic barium swallow study.Methods: This is a descriptive-analytical study. SOMA was assessed on 52 children with swallowing problems. The children were 6 to 48 months and had been referred for a fluoroscopic barium swallow. We analyzed sensitivity; specificity, positive predictive value, and negative predictive value of SOMA, with the fluoroscopic barium swallow as the gold standard. For the evaluation of the correlations among variables, Cronbach's coefficient alpha was calculated.Results: In this study 6 parts of SOMA had 0-25% sensitivity, 90-97% specificity, 0-66% positive predictive value, 84-87% negative predictive value, 78-86% compatibility percent and 0.06-0.17 kappa value. Internal consistency was 0.93 using Cronbach's coefficient alpha.Conclusion: The results of this study suggest that SOMA is valid for the evaluating of swallowing disorders. It can use as a screening test and as a complementary method to fluoroscopic barium swallow.

Introduction: Feeding is an interactive process between a child and a caregiver, and its early and chronic problems can affect the stress and quality of life of parents. Since the health and support of caregivers can affect the child's disability and performance, it is important to consider the impact of feeding and swallowing disorders on caregivers. Hence, the present study aimed to translate and investigate the validity and reliability of the Feeding/Swallowing Impact Survey (FS-IS) in Persian. Methods: This methodological study consisted of two phases: translating the test to Persian (P-FS-IS) and evaluating psychometric properties including face and content validity (through experts' opinions and cognitive interviews), construct validity (by known-group validity and exploratory factor analysis), and reliability of the questionnaire (by internal consistency and test-retest reliability). The present study was performed on 97 Iranian mothers of children with cerebral palsy aged 2–18 years with swallowing impairments. Results: Exploratory factor analysis rendered two factors with a cumulative variance of 59.71%. When evaluating known-group validity, the questionnaire scores were significantly different across the groups with different severity of the disorder (F(2, 94) = 57.1, p ≤ 0.001). P-FS-IS had a high internal consistency with Cronbach's alpha of 0.95, and there was an appropriate intra-class correlation coefficient of 0.97 for the total questionnaire. Conclusion: P-FS-IS has good validity and reliability and is a suitable questionnaire for assessing the impact of pediatric feeding and swallowing disorders on Persian language mothers. This scale can be used in research and clinical settings to evaluate and determine therapeutic goals. [ABSTRACT FROM AUTHOR]

Objective Swallowing disorder or dysphagia is one of the most common problems in old age and after brain vascular lesions. This problem has received a lot of attention in studies. However, Pain on swallowing (known as odynophagia) has been less discussed in the literature. The present study aimed to investigate the existence of pain on swallowing, its characteristics, the possible intervention, and the effects of this pain on the quality of life of affected people. Materials & Methods The present study adopted a qualitative approach. After purposeful sampling, we interviewed 11 speech therapists in the field of swallowing disorders (5 males) and 15 patients with dysphagia. All the interviews were transcribed and underwent content analysis using the Graneheim and Lundman method. Finally, the main themes, subcategories, semantic units, and examples related to each were obtained. Results Out of 15 interviewed patients, only 6 reported pain on swallowing. In comparison, all 11 therapists in the field of swallowing disorders confirmed the presence of pain on swallowing. Seven main themes were obtained based on these interviews: The temporal pattern, duration, location, stimulating/provoking factors, type, intensity, and onset time. Each of these themes had its subcategories and items. All patients and therapists reported the negative impact of pain on swallowing on the quality of life. There was an agreement between therapists and patients to manage pain on swallowing. Conclusion This study showed that pain on swallowing is probably one of the characteristics of a swallowing disorder, and professionals must consider pain on swallowing during the clinical examination. Future studies can focus on different dimensions of pain on swallowing and develop proper evaluation scales. [ABSTRACT FROM AUTHOR]

Background: Oropharyngeal dysphagia is highly prevalent among hospitalized geriatric patients. The screening instruments used to date have been evaluated primarily in stroke patients. This diagnostic study aimed to validate a new screening instrument for oropharyngeal dysphagia, the 'Dysphagia Screening Tool for Geriatric Patients' (DSTG), as compared to one of the gold standards, flexible endoscopic evaluation of swallowing (FEES). Materials and methods: Geriatric inpatients admitted to five geriatric hospitals in Germany were consecutively evaluated using both DSTG and FEES in random order and by different evaluators blinded to the results of the other evaluation. In the FEES examination, a score of more than 3 on Rosenbek's Penetration Aspiration Scale was considered evidence of clinically relevant oropharyngeal dysphagia. Sensitivity, specificity and further measures of test performance were calculated for DSTG. Results: The 53 volunteers recruited were on average 85 years of age, 56.6% were women. Twenty patients (37.7%) were diagnosed with dysphagia using FEES. Of these, 12 were screened as positive on DSTG. Of the 33 FEES negative patients, 4 tested positive on DSTG. The following test parameters were calculated for DSTG: sensitivity: 0.60, 95% confidence interval [0.39 ; 0.78], specificity 0.88 [0.73 ; 0.95], positive predictive value 0.75 [0.51 ; 0.90], negative predictive value 0.78 [0.63 ; 0.89], positive likelihood ratio 4.95 [1.85 ; 13.27], negative likelihood ratio 0.46 [0.26 ; 0.79]. In a receiver-operator characteristic (ROC) curve analysis, the area under the curve (AUC) was 0.77 [0.62 ; 0.91]. No adverse events occurred. Conclusion: The DSTG appears to be a valid instrument for screening of oropharyngeal dysphagia in geriatric inpatients. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of endotracheal suctioning method using suctioning sputum with suctioning salivary tube in patients with craniocerebral injury undergoing tracheotomy. Methods A randomized controlled trial was conducted in 106 patients with traumatic brain injury after tracheotomy who met the inclusion criteria. According to the random number table method, they were divided into two groups, with 53 cases in each group. The experimental group was treated with endotracheal suctioning method using sputum suction tube combined with sputum suction tube, while the control group was treated with routine sputum suction method using sputum suction tube . The secretion severity grade under electronic laryngoscope swallowing function assessment (FEES) before and after sputum aspiration was compared between the two groups. The number of sputum aspiration, blood oxygen saturation and heart rate changes at 1 minute before and after sputum aspiration were observed in the two groups at 1, 3 and 7 days after admission. The mucosal damage under electronic hose bronchoscopy was observed in the two groups at 1, 3 and 7 days after admission. Results The severity of FEES was significantly lower in the experimental group than in the control group (P

BACKGROUND: Previous clinical studies have found that acupoint dressing therapy using Expectorant Choking Formula is effective in improving swallowing function in patients with post-stroke swallowing disorders, but the mechanism of action is unclear. In the brainstem swallowing center, the nucleus ambiguus is the main component of the swallowing center in the ventral region, which can induce swallowing movements and swallowing time, while glutamate receptors, γ-aminobutyric acid receptors, and c-fos protein in the nucleus ambiguus are closely related to swallowing. OBJECTIVE: To investigate the effects of acupoint dressing therapy using Expectorant Choking Formula on the expression of glutamate receptors, γ-aminobutyric acid receptors, and c-fos protein in the nucleus ambiguus of rats with ischemia-reperfusion injury, and to investigate the mechanism of swallowing disorder in rats with cerebral ischemia-reperfusion treated by acupoint dressing therapy using Expectorant Choking Formula. METHODS: Seventy Sprague-Dawley rats were randomly divided into normal group (n=16), ischemia-reperfusion injury model group (n=18), patching group (n=18), and sham patching group (n=18). The model group, patching group, and sham patching group were modeled by reperfusion after 90 minutes of transient cerebral ischemia using the thread-occlusion method. After 6 hours of modeling, neurological function was scored and the rats with a score of 2 were selected for subsequent experiments. The rats were treated with acupoint dressing therapy using Expectorant Choking Formula on the second day of modeling, the sham patching group was given drug-free dressing on the basis of the model preparation, and the other two groups were kept normally for 1 month. Body mass, swallowing initiation response time and the number of swallows were recorded in each group on days 2, 7, 14 and 30 after modeling. After 4 weeks of treatment, the water content in brain tissue was measured; the expression of gamma-aminobutyric acid A receptor α1, N-methyl-D-aspartate receptor 1 and c-fos protein in the nucleus ambiguus of the medullary swallowing center was detected by immunohistochemistry, RT-PCR and western blot. RESULTS AND CONCLUSION: Compared with the normal group, the body mass, the number of swallows within 1 minute and swallow initiation reaction time of rats in the model, patching and sham patching groups decreased on days 14 and 30 after modeling (P < 0.05), and the swallow initiation reaction time was prolonged (P < 0.05); on day 30, the body mass and the number of swallows of rats increased in the patching group compared with the model group (P < 0.05), while the swallowing initiation time was shortened (P < 0.05). After 4 weeks of treatment, the water content of brain tissue was significantly reduced in the patching group compared with the model group (P < 0.05). Compared with the model group, the positive expression and the mRNA and protein expression of gamma-aminobutyric acid A receptor α1 in the nucleus ambiguus of the medulla oblongata were increased in the patching group but still lower than those in the normal group; the positive expression and the mRNA and protein expression of N-methyl-D-aspartate receptor 1 and c-fos were decreased in the patching group but significantly higher than those in the normal group (P < 0.05). These findings indicate that the acupoint dressing therapy using Expectorant Choking Formula could improve the swallowing function of rats with post-stroke swallowing disorder, and its mechanism of action might be related to improving the degree of brain edema, regulating the neurotransmitters glutamate receptors, gamma-aminobutyric acid A receptors and c-fos protein levels in the nucleus ambiguus. [ABSTRACT FROM AUTHOR]

Sarcopenic dysphagia (SD) is an emerging concern in geriatric medicine. This study aimed to identify the prevalence, progression, and distinct attributes of SD in patients in the Department of Geriatric Medicine. Older adult patients admitted between 2021 and 2022 were enrolled. The department conducts a comprehensive geriatric assessment (CGA) combined with a multidisciplinary team-based intervention, setting the standard for medical care. We diligently assessed the occurrence and development of dysphagia at both the admission and discharge phases. Of the 180 patients analyzed (38.9% male, mean age 86.0 ± 6.6 years), 22.8% were diagnosed with SD at admission, thrice the rate of other dysphagia variants. Only one patient had new-onset dysphagia during hospitalization, attributed to SD. Patients with SD showed a better recovery rate (18.9%) than those with other dysphagia types. Patients with diminished swallowing capacity had compromised nutritional profiles, diminished energy and protein consumption, and extended fasting durations. Although sarcopenia is a prevalent inducer of dysphagia in older adults, an integrated approach in geriatric medicine involving rehabilitation, nutrition, and dentistry is pivotal. Strategies rooted in CGA promise potential for addressing dysphagia. [ABSTRACT FROM AUTHOR]

To provide normative data on swallowing capacity (mL/s) in people older than 60 years using the Timed Water Swallow Test (TWST), stratified by sex. Intra- and inter-rater reliability for swallowing time in TWST was further investigated. A total of 165 participants, aged 60 years and above, were included in the study. The time taken to consume 150 mL of tap water and the swallowing capacity (mL/s) was observed in a clinical context using the TWST. Video recordings of the performances were collected for 118 of the 165 participants for inter-rater reliability testing, of which a random set of 25 performances were assessed for intra-rater reliability. Analysis of the agreement between TWST rated by an in-person clinician and rated from a video recording was further evaluated. There were significant age and sex effects observed for swallowing capacity. The average reduction in swallowing capacity in the investigated age range (60–92 years) was 8.8 and 7.3 mL/s, for women and men respectively. The results showed high inter-and intra-rater reliability and agreement between the clinical assessment and the video recording. The presented measurements indicate a clear effect of age on swallowing capacity and that women may be expected to have lower capacity scores than men when tested using TWST. The provided norms can be used as reference points in the clinical identification of people at risk of dysphagia in the older population. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus with increasing incidence and dysphagia as the main symptom. The management of suspected or known EoE by Austrian endoscopists has not been investigated yet. Methods: A web-based survey with 13 questions about the management of EoE was sent to endoscopists via the Austrian Society of Gastroenterology and Hepatology (ÖGGH). Results: A total of 222 endoscopists (74% gastroenterologists, 23% surgeons, and 2% pediatricians; 68% working in a hospital) from all 9 states participated. In patients with dysphagia but a normal appearing esophagus, 85% of respondents reported always taking biopsies; however, surgeons were less likely to obtain biopsies compared to gastroenterologists ("always" 69% vs. 90%, "sometimes" 29% vs. 10%, "never" 2% vs. 0%, p < 0.001). The approved budesonide orodispersible tablet is the preferred first-line drug used in EoE, ahead of proton pump inhibitors (PPI). Only 65% of participants monitor the patients by endoscopy and histology after 12 weeks of induction therapy, 26% do not continue maintenance therapy, and 22% monitor patients only when symptomatic. Conclusion: The vast majority of Austrian endoscopists adhere to the European and US guidelines in cases of suspected EoE. In contrast, despite the chronic disease course, a significant percentage of providers indicate not to use maintenance therapy and monitor the patients routinely. [ABSTRACT FROM AUTHOR]

Objectives There has been increased interest in using telepractice in clinical services during COVID-19. Using telepractice is little known in speech and language therapy. However, the parents and speech therapists were satisfied with this method. Therefore, this scoping review aims to compare tele speech therapy and face-to-face speech therapy during the COVID-19 pandemic and determine the efficacy of available telepractices in speech therapy. Materials & Methods This scoping review was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guideline. The authors systematically searched Web of Science, PubMed, and Scopus databases with specific eligibility criteria. The eligibility criteria were studies published from 1 January 2020 to 10 May 2023 from a peer-reviewed journal and written in English. In addition, the articles were about speech therapy in children during COVID-19. Results Fifteen articles were included in this scoping review. Results showed that approximately all speech therapists used tele practice during the pandemic. Parents and students are satisfied with this method but have problems with it. On the other hand, some parents and SLPs preferred tele practice accompanied by face-to-face intervention. Furthermore, few studies determined the efficacy of tele practice with clear structural methods in specific populations. Conclusion Although tele speech therapy is acceptable for providing speech and language therapy services to children with swallowing and communication disorder, speech-language therapists should increase their information and technology to achieve successful results. Moreover, parents must play an essential role in telepractice services to facilitate effective communication between clinicians and families. [ABSTRACT FROM AUTHOR]

Oropharyngeal dysphagia (OD) is a frequent finding in older patients with potentially lethal complications such as aspiration pneumonia, malnutrition, and dehydration. Recent studies describe sarcopenia as a causative factor for OD, which is occasionally referred to as "sarcopenic dysphagia" in the absence of a neurogenic etiology. In most of the previous studies on sarcopenic dysphagia, the diagnosis was based only on clinical assessment. In this study, flexible endoscopic evaluation of swallowing (FEES) was used as an objective method to evaluate the presence of OD, its association with sarcopenia, and the presence of pure sarcopenic dysphagia. In this retrospective cross-sectional study, 109 acute care geriatric hospital patients with suspected OD received FEES examination and bioimpedance analysis (BIA) in clinical routine. 95% of patients had at least one neurological disease, 70% fulfilled the criteria for sarcopenia, and 45% displayed moderate or severe OD. Although the prevalence of sarcopenia and OD was high, there was no significant association between OD and sarcopenia. Considering these results, both the association between sarcopenia and OD and pure sarcopenic dysphagia appear questionable. Further prospective studies are needed to elucidate if sarcopenia is merely an epiphenomenon of severe disease or whether it plays a causative role in the development of OD. [ABSTRACT FROM AUTHOR]

To establish a generally accepted Danish definition of dysphagia to enhance collaboration across sectors and professions. The study was initiated by a multi-professional group of experienced researchers and board members of the Danish Society for Dysphagia. We used a modified Delphi methodology to achieve consensus among experienced health care professionals from different professions and contexts. The initial stage consisted of a literature search leading to the draft of different definitions followed by two Delphi rounds between professionals and a stakeholder consultation round. We conducted two Delphi rounds until one definition was clearly preferred. A total of 194 participants responded in round one, and 279 in round two. Both rounds had a broad representation of sectors and geography and most participants had worked with dysphagia for more than four years. The preferred definition was 'Dysphagia is a functional impairment that either prevents or limits the intake of food and fluids, and which makes swallowing unsafe, inefficient, uncomfortable or affects quality of life'. The definition was widely accepted among different health professional groups, patients and across sectors. [ABSTRACT FROM AUTHOR]

To examine quality, readability, understandability, and actionability of English-language online educational materials about dysphagia. A Google search of "dysphagia" and related terms was conducted. Web page quality and accountability were measured using HON and URAC certification seals, the DISCERN instrument, and JAMA benchmark criteria. Understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Printed Material (PEMAT-P). Readability was assessed using the Flesch Reading Ease (FRE), Flesch–Kincaid Grade Level (F-KGL), Gunning Fog (FOG), and the Simple Measure of Gobbledygook (SMOG) scores using dedicated readability software. Fifty web pages were analyzed. Seventeen web pages displayed a HON or URAC seal. DISCERN scores ranged from 17 to 50 (Mdn = 25.00; IQR = 32.25–21.00). Of the JAMA benchmark criteria, 88% of web pages met the disclosure criterion, while only 22% met the authorship, 20% met the attribution, and 16% met the currency criteria. PEMAT-P understandability and actionability scores were 69.38% ± 11.14% and 28.58% ± 22.19%, respectively. Readability scores, on average, exceeded the recommended grade reading levels for health information (FRE 46.34 ± 13.59, F-KGL 10.26 ± 2.29, FOG 12.11 ± 2.08, and SMOG 12.38 ± 1.70). Online materials about dysphagia can be improved by obtaining quality certificates and by including content that is more readable and easier to understand and act upon. [ABSTRACT FROM AUTHOR]

Purpose: Oropharyngeal dysphagia is one of the most common postoperative consequences in head and neck cancer patients. Above all, these patients often suffer from aspiration and limitations of oral intake. However, no reliable dysphagia screening is available for this target group. This study aimed to develop and validate a screening, FraMaDySc, based on a water swallow test (WST) for the identification of postsurgical patients with a risk of aspiration, limitations of oral intake, and, as their derivate, a relevant oropharyngeal dysphagia in general (OD) that constituted the main reference standard. Methods: A total of 184 postsurgical head and neck cancer patients were tested with a WST. The patients were, on average, 62 years old and predominantly male (71%). After WST, they underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES®). FEES® results were dichotomized by Penetration aspiration scale and Functional oral intake scale. Patients with a "fail" result on one of these two scales were classified as having OD. Quality criteria of WST were quantified by means of cross-tabulation with FEES® results. Results: OD was found in 65% of patients, aspiration in 44%, limitations of oral intake in 56%. WST delivered a "fail" result in 65% of patients. WST showed sensitivity 91% and specificity 88% for OD. Quality criteria for aspiration (sensitivity 64%, specificity 93%) and limitations of oral intake (sensitivity 80%, specificity 87%) were lower. Conclusion: FraMaDySc is a standardized, quick, and valid WST and therefore an excellent screening tool for the identification of OD in postoperative head and neck cancer patients. [ABSTRACT FROM AUTHOR]

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Abstract Background Swallowing difficulties in the oral cavity or pharynx (i.e., oropharyngeal dysphagia) are a common problem in the aging population, which may result in severe consequences, such as malnutrition, aspiration pneumonia, and mortality. Identifying oropharyngeal dysphagia and its associated factors is essential for establishing better healthcare policies in nursing homes. In this study, we aimed to describe the oropharyngeal dysphagia prevalence among nursing home residents, and to investigate the association between dysphagia and potentially related factors in a large survey of nursing home residents in Sweden, including individuals with various degrees of cognitive impairment. A secondary aim was to compare findings between years on oropharyngeal dysphagia and its associated factors. Methods This study is based on two cross-sectional surveys performed in 2007 and 2013, including 4,995 individuals living in nursing homes in the Region of Västerbotten, Sweden. Data were collected from caregivers’ reports regarding swallowing ability, nutritional status, chewing ability, and other baseline characteristics, such as cognitive function and activity of daily living (ADL). Data were analyzed using logistic regression models to calculate the odds of the association between oropharyngeal dysphagia and associated factors. Results Oropharyngeal dysphagia was reported in 14.9% (95% CI: 13.9–16.0) of the nursing home residents. An adjusted model revealed that oropharyngeal dysphagia was associated by severe cognitive impairment (OR: 1.56, 95% CI: 1.14–2.12) and ADL independence (OR: 0.81 95% CI: 1.82–2.66) among nursing home residents. We also identified the following as independently associated factors of dysphagia: reduced nutritional status (OR: 1.84, 95% CI: 1.49–2.27), artificial nutrition (OR: 6.33, 95% CI: 2.73–14.71), and clinical signs of aspiration (OR: 10.89, 95% CI: 8.40–14.12). Conclusions Oropharyngeal dysphagia was reported among approximately 15% nursing home residents and was associated with cognitive impairment and ADL capability. Furthermore, reduced nutritional status and artificial nutrition were also associated with oropharyngeal dysphagia. Implementing routine protocols in nursing homes may help detect oropharyngeal dysphagia and manage oropharyngeal dysphagia among residents.

Cerebrovascular accident is the most common disorder in the older adult population and can impair the swallowing function, resulting in neurogenic dysphagia with greater occurrence in its acute phase. This study aimed to check how the oropharyngeal dysphagia degree impacts the oral intake and nutritional status of older adults affected by cerebrovascular accident in the late stage after stroke. This is a retrospective cross-sectional study. According to the Dysphagia Outcome and Severity Scale (DOSS), three judges classified the oropharyngeal dysphagia after analyzing the instrumental evaluation of swallowing images captured through fiberoptic endoscopic evaluation of swallowing (FEES). The level of oral intake classification (FOIS) was performed by reviewing the usual patterns of food intake reported in the 24-hour food recall, and the nutritional status assessment was performed using data from the Mini Nutritional Assessment (MNA®) and anthropometric measurements: weight, height, body mass index (BMI), circumferences (arm), skin folds (triceps; biceps; subscapular; suprailiac). Researchers included 25 older adult subjects (14 male and 11 female) with an average age of 72 years old. A positive correlation was found between the oropharyngeal dysphagia degree and FOIS (p = 0.051), screening score (p = 0.011), and total score (p = 0.006) of the MNA® protocol, as well as between the classification of FOIS levels with the BMI (p = 0.029) and anthropometric measurements referring to muscle mass – AC (p = 0.021), AMC (p = 0.010) and AMA (p = 0.023). That leads to the conclusion that, although most research individuals had functional swallowing or mild dysphagia, their dysphagia influenced their level of oral intake and nutritional status. [ABSTRACT FROM AUTHOR]

Patients with dysphagia diseases require food with acceptable textural characteristics. Additionally, due to the consumption of smaller portions, these patients receive insufficient amounts of nutrients. Therefore, this study aimed to develop plant-based purée as a meal for an oro-pharyngeal dysphagia (OD) diet, enriched with proteins, fiber and antioxidant vitamins. The suitability of three protein sources—soy protein isolate, whey protein isolate and brown pea protein concentrate—was tested through evaluation of their effect on the rheological properties of protein-enriched plant-based purées for OD diets. Based on the rheological analysis, whey protein was selected for incorporation into the new product formulations. Two prototypes of soups and two prototypes of desserts produced in this study demonstrated acceptable textural properties and high nutritional value. [ABSTRACT FROM AUTHOR]

ObjectivesThis study aims to review the documents on dysphagia, summarize the research direction, analyze the research hot spots and frontiers, report the research trends, and provide new ideas for future development in the field via CiteSpace.MethodsWe retrieved articles on dysphagia published between 2012 and 2021 from the Web of Science Core Collection database. We downloaded the entire data and utilized CiteSpace version 5.8.R3 (64-bit) to analyze the number of publications annually, cited journals, countries, institutions, authors, cited authors, cited references, and keywords. We visualized the data with a knowledge map, collaborative network analysis, cluster analysis, and strongest citation burst analysis.ResultsWe obtained 14,007 papers with a continually increasing trend over time. The most productive country and institute in this field were the United States (4,308) and Northwestern University (236), respectively. Dysphagia (5,062) and Laryngoscope (2,812) were the most productive journals, Elizabeth Ward had the highest number of publications (84), and Logeman et al.'s article (centrality: 0.02) was the most referenced. The most common keywords were dysphagia, management, quality of life, deglutition disorder, diagnosis, aspiration, prevalence, children, outcome, and oropharyngeal dysphagia.ConclusionThis study analyzed the current literature on dysphagia via CiteSpace and identified its research hot spots and frontiers. The prevalent global trends in dysphagia research and the growing public awareness about healthcare and quality of life suggest that research on dysphagia will gain popularity with further breakthroughs.

Abstract Mucopolysaccharidoses (MPS) are rare inborn errors of metabolism, leading to the accumulation of glycosaminoglycans (GAG) in distinct tissues. We investigated oropharyngeal dysphagia using the videofluoroscopic swallowing study (VFSS) in patients with different MPS types. Since there is a lack of studies systematically evaluating this disorder in this population, the use of a standard technique should contribute to better evaluate individuals with MPS. A cross-sectional and observational study enrolling patients followed by an outpatient service for lysosomal diseases at the Genetics Service of the Hospital de Clínicas de Porto Alegre (SGM/HCPA) was conducted. Patients underwent semi-structured interviews, clinical evaluation and VFSS. Nineteen patients were evaluated, including patients with MPS types I (16%), II (42%), IIIb (10%) and IVa (32%). Nearly all patients (95%) presented with oropharyngeal dysphagia in the VFSS. The most frequent findings were impaired chewing during oral phase (94%) and reduced laryngeal elevation in the pharyngeal phase (72%). Oropharyngeal dysphagia constituted a prevalent symptom in the studied cohort regardless of MPS type. Our data reinforces the notion that this disorder should be objectively assessed since it can significantly compromise the nutrition and the hydration of these patients as well as lead to tracheobronchial aspiration, thus resulting in aspiration pneumonia and even death eventually.

Background: Oropharyngeal dysphagia (OD) is a relevant disease among older adults and is associated with serious adverse health-related outcomes, such as malnutrition, sarcopenia, or frailty. Increasing its recognition and the related mechanisms will allow us to its prevention and treatment at different levels of care. Objectives: This study aimed to determine the prevalence and biological correlates of OD in outpatient older adults. Method: This is a cross-sectional study including 100 adults aged 60 or older from a geriatric clinic of a tertiary hospital in Mexico City. Health variables and geriatric syndromes were recorded. The Eating Assessment Tool-10 detection test and the volume-viscosity swallowing test were used to diagnose OD. Logistic regression models were performed to identify the factors associated with OD. Results: Mean age was 81.2 (±7.5) years and 21% had OD. The presence of xerostomia (p = 0.05) and a worst nutritional status (p = 0.035) were obtained. Conclusions: The prevalence of OD among older adults was high. Inadequate nutrition status and the presence of xerostomia are more likely to be present with this swallowing disorder. [ABSTRACT FROM AUTHOR]

In older adults, community-acquired pneumonia (CAP) is often aspiration-related. However, as aspiration pneumonia (AP) lacks clear diagnostic criteria, the reported prevalence and clinical management vary greatly. We investigated what clinical factors appeared to influence the diagnosis of AP and non-AP in a clinical setting and reconsidered a more clinically relevant approach. Medical records of patients aged ≥75 years admitted with CAP were reviewed retrospectively. A total of 803 patients (134 APs and 669 non-APs) were included. The AP group had significantly higher rates of frailty, had higher SARC-F scores, resided in institutions, had neurologic conditions, previous pneumonia diagnoses, known dysphagia, and were more likely to present with vomiting or coughing on food. Nil by mouth orders, speech therapist referrals, and broad-spectrum antibiotics were significantly more common, while computed tomography scans and blood cultures were rarely performed; alternative diagnoses, such as cancer and pulmonary embolism, were detected significantly less. AP is diagnosed more commonly in frail patients, while aspiration is the underlying aetiology in most types of pneumonia. A presumptive diagnosis of AP may deny patients necessary investigation and management. We suggest a paradigm shift in the way we approach older patients with CAP; rather than trying to differentiate AP and non-AP, it would be more clinically relevant to recognise all pneumonia as just pneumonia, and assess their swallowing functions, causative organisms, and investigate alternative diagnoses or underlying causes of dysphagia. This will enable appropriate clinical management. [ABSTRACT FROM AUTHOR]

The aim of this prospective, observational study was to evaluate the effectiveness of a simple endoscopic method for scoring swallowing function after treatment of advanced head and neck cancer patients. A prospective, observational study was conducted involving 60 patients who had undergone surgery or chemoradiation for advanced head and neck cancer. Endoscopic score of swallowing function, penetration aspiration scale (PAS) score measured by videofluorography, and functional oral intake scale (FOIS) score were recorded, and their correlations were examined. There was a positive correlation between endoscopic and PAS scores. Patients with endoscopic scores of 4 points or more had significantly higher PAS scores and lower FOIS scores than those with scores of 3 points or less. These positive correlations were found only in patients who underwent surgery, and not those who received chemoradiation. This study showed the effectiveness of the simple endoscopic method for scoring swallowing function in patients after surgery for advanced head and neck cancers. [ABSTRACT FROM AUTHOR]

Objective: To observe the clinical effect of tongue three needle combined with sublingual collateral puncture and bloodletting in the treatment of swallowing dysfunction after stroke. Methods: A prospective randomized controlled study divided 60patients with poststroke swallowing disorders between January 2018 and January 2021 into matched group(30 patients) and therapy group(30 patients). The matched group were given swallowing function training, and the therapy group were given "tongue three needle" acupuncture combined with sublingual collateral puncture and bloodletting on the basis of the matched group. Before and Post-treatment, the scores of Wada drinking water test system and the swallowing disorder-specific quality of life scale(SWAL-QOL)were used to evaluate the two groups of patients. Their clinical efficacy were assessed and satisfaction were surveyed. Results:Post-treatment, the scores of Wada drinking waterin of both groups were significantly decreased(P<0.05), while the scores of Wada drinking water in the therapy group was significantly lower than that in the matched group(P<0.05). The SWAL-QOL scores of both groups were significantly improved(P<0.05), while the SWAL-QOL scores in the therapy group was significantly higher than that in the matched group(P<0.05). The total effective rate in the therapy group(80.00 %) was significantly higher than that in the matched group(56.67 %)(P<0.05). The overall satisfaction of the research group(96.67 %) was significantly higher than that of the matched group(60.00 %)(P<0.05). Conclusion: Tongue three-needle combined with sublingual pricking and bloodletting has a positive effect on the treatment of post-stroke dysphagia. It has a synergistic effect with swallowing function training, and can effectively improve the quality of life of patients. It is safe, tolerated, and has high patient satisfaction,which were worth of clinical application. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of family member participation nursing on depression of patients with dysphagia. Methods A total of 72 patients with dysphagia were selected and divided into control group and intervention group, with 36 cases in each group. The control group was given routine rehabilitation nursing, and the intervention group was given family member participation nursing on the basis of the control group. The nursing ability of family members, depression degree score and quality of life score of the two groups were observed on the first day of hospitalization and one month after intervention. Results After intervention, the Family Caregiver Task Inventory(FCTI) score of family members in intervention group was better than that in control group (P＜0. 01). The Hamilton Depression Scale(HAMD) in the intervention group was lower than that of control group(P＜0. 05), and the Swallow Quality-of-Life Questionnaire (SWAL-QoL)score in the intervention group was higher than that of control group (P＜0. 05). Conclusion Family participation nursing can improve the care ability of family members of patients with dysphagia, improve the depression state and improve the quality of life of patients. (目的 探讨家属参与型护理对吞咽障碍患者抑郁状态的影响。方法 选取2019年8月—2021年8月中国科学院大学深圳医院(光明)收治的吞咽障碍患者72例, 分为对照组和干预组, 各36例。对照组给予常规康复护理, 干预组在对照组基础上增加家属参与型护理。对比观察住院第1天及干预1个月后2组患者家属的照顾能力、患者抑郁程度评分和生活质量评分情况。结果 干预后, 干预组患者家属照护能力量表(FCTI)评分低于对照组, 差异有统计学意义(P＜0. 01)。干预组患者汉密尔顿抑郁量表(HAMD)评分低于对照组, 吞咽障碍生活质量量表(SWAL-QOL)评分高于对照组, 差异有统计学意义(P＜0. 01)。结论 家属参与型护理能提高吞咽障碍患者家属照顾能力和改善抑郁状态, 提升患者生活质量。)

Dysphagia is a risk factor that impaires an individual's experience of mealtimes. Few studies contribute to the knowledge on the health-related quality of life (HRQoL) of citizens with oropharyngeal dysphagia (OD) living independently. The aim of this study involves evaluating the HRQoL in citizens living independently and suffering from OD. This cross-sectional study was performed in seven municipalities in Denmark between March 2019 and December 2020. The 90 citizens included (54% female, mean age 76.6 years (SD 0.8)) were ≥18 years, as well as diagnosed with OD using the volume-viscosity swallow test and Minimal Eating Observation Form version II. The Dysphagia Handicap Index-DK, Barthel 20, and European Quality of Life-5 Dimensions were fulfilled. Of the participating citizens, 66% of them needed additional time to eat, 64% coughed while eating, and 58% coughed while drinking. Additionally, 60% reported having a dry mouth, 62% needed to drink to succeed with swallowing foods, and 57% had to swallow multiple times. About one-third felt embarrassed when eating with others. They could not enjoy eating in the same manner as they had previously, and/or felt handicapped or limited. OD was shown to have had a high impact on the QoL in citizens with OD living independently. Focus is needed on xerostomia, as well as on the psychological aspects pertainings to mealtimes for citizens with OD. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities often face a number of disorders that can impair their health and even endanger their lives. One of these disorders is dysphagia, which is often unrecognized in this population. The main goal of the research was to determine the differences in the severity of dysphagia relation to the degree of intellectual disability in persons placed in institutional accommodation. The study involved 31 respondents diagnosed with intellectual disabilities. The results showed that people with a higher degree of intellectual disability have more pronounced dysphagia. Caregivers of people with intellectual disabilities should be aware of the presence of dysphagia in people with intellectual disabilities, and refer them to a speech-language pathologist in a timely manner with the goal of timely diagnosis and treatment to improve the overall health and quality of life of people of this population.

Objective: To evaluate the impact of radiotherapy (RT) on dysphagia and long-term swallowing outcome in patients with stage III and IV head and neck squamous cell carcinomas (HNSCCs). Material and Methods: Between 2005 and 2008, 189 patients with HNSCCs underwent primary or adjuvant RT in a curative setting. Long-term swallowing outcome was evaluated in 50 patients. Among them, 26 were further eligible for prospective analysis of long-term swallowing and dysphagia outcome. Medical charts were retrospectively reviewed regarding pre- and post-treatment dysphagia (3 months after last irradiation setting) as well as persisting long-term dysphagia (2019–2021). Results: Pre-treatment dysphagia was observed in 24 (48%) of 50 patients, particularly in oropharyngeal or hypopharyngeal stage III–IV tumors (OR 9.3; p = 0.003). Conversely, 46 patients (92%) complained about post-treatment dysphagic symptoms, which were more commonly seen in patients with positive neck nodes (OR 10.5; p = 0.037). The post-treatment dysphagia rate dropped from 92% to 24% (p < 0.001) during surveillance, which was significantly linked to xerostomia (OR 5.77; p = 0.019), dysgeusia (OR 9.9; p = 0.036) and free flap reconstruction (OR 6.1; p = 0.022). Conclusion: Pretreatment dysphagia is common in advanced stage HNSCCs and almost all patients complain about dysphagia at the end of RT. Importantly, applied RT protocols did not affect long-term dysphagia, which improves significantly in the majority of patients over time. Meeting Information: Preliminary results have been presented at the 65th Annual Meeting of the Austrian Society of Otorhinolaryngology, 22–26 September 2021, Austria. [ABSTRACT FROM AUTHOR]

Background: Swallowing difficulties in the oral cavity or pharynx (i.e., oropharyngeal dysphagia) are a common problem in the aging population, which may result in severe consequences, such as malnutrition, aspiration pneumonia, and mortality. Identifying oropharyngeal dysphagia and its associated factors is essential for establishing better healthcare policies in nursing homes. In this study, we aimed to describe the oropharyngeal dysphagia prevalence among nursing home residents, and to investigate the association between dysphagia and potentially related factors in a large survey of nursing home residents in Sweden, including individuals with various degrees of cognitive impairment. A secondary aim was to compare findings between years on oropharyngeal dysphagia and its associated factors.Methods: This study is based on two cross-sectional surveys performed in 2007 and 2013, including 4,995 individuals living in nursing homes in the Region of Västerbotten, Sweden. Data were collected from caregivers' reports regarding swallowing ability, nutritional status, chewing ability, and other baseline characteristics, such as cognitive function and activity of daily living (ADL). Data were analyzed using logistic regression models to calculate the odds of the association between oropharyngeal dysphagia and associated factors.Results: Oropharyngeal dysphagia was reported in 14.9% (95% CI: 13.9-16.0) of the nursing home residents. An adjusted model revealed that oropharyngeal dysphagia was associated by severe cognitive impairment (OR: 1.56, 95% CI: 1.14-2.12) and ADL independence (OR: 0.81 95% CI: 1.82-2.66) among nursing home residents. We also identified the following as independently associated factors of dysphagia: reduced nutritional status (OR: 1.84, 95% CI: 1.49-2.27), artificial nutrition (OR: 6.33, 95% CI: 2.73-14.71), and clinical signs of aspiration (OR: 10.89, 95% CI: 8.40-14.12).Conclusions: Oropharyngeal dysphagia was reported among approximately 15% nursing home residents and was associated with cognitive impairment and ADL capability. Furthermore, reduced nutritional status and artificial nutrition were also associated with oropharyngeal dysphagia. Implementing routine protocols in nursing homes may help detect oropharyngeal dysphagia and manage oropharyngeal dysphagia among residents. [ABSTRACT FROM AUTHOR]

Abstract Background Oral and pharyngeal swallowing dysfunction are common complications in acute stroke patients. This primary aim of this study was to determine whether oral neuromuscular training improves swallowing function in participants with swallowing dysfunction after stroke. A secondary aim was to assess how well results of the timed water-swallow test (TWST) correspond with swallowing dysfunction diagnosed by videofluoroscopy (VFS). Methods This was an intention-to-treat two-centre prospective randomized open-label study with blinded-evaluators (PROBE) design. At 4 weeks after stroke onset, participants with swallowing dysfunction were randomized to 5 weeks of continued orofacial sensory-vibration stimulation with an electric toothbrush or additional oral neuromuscular training with an oral device (Muppy®). Participants were examined with TWST, a lip-force test, and VFS before (baseline), after 5 weeks’ treatment (the end-of-treatment), and 12 months after treatment (follow-up). The baseline VFS results were compared with the TWST results. The primary endpoint was changes in swallowing rate assessed using TWST, from baseline to the end of training and from baseline to follow-up based on intention-to-treat analyses. The secondary endpoint was the corresponding changes in lip-force between baseline, the end of treatment, and follow-up. Results The participants were randomly assigned as controls (n = 20) or for intervention with oral neuromuscular training (n = 20). After treatment, both groups had improved significantly (intervention, P

Abstract Background Persistent swallowing disorders (SD) are non-pulmonary complications of mechanical ventilation (MV). However, there are few clinical studies on persistent SD in critically ill patients undergoing tracheal intubation for MV. The aim of the present study was to assess the incidence and characteristics of clinical manifestations associated with persistent SD. Methods We prospectively evaluated in patients requiring more than 7 days of invasive MV the incidence and characteristics of clinical manifestations related to persistent SD. For this purpose, quality of swallowing was assessed within 24 h after extubation by an experienced physical therapist not directly involved in patient management. Swallowing assessment consisted in a specific standardized test combining a swallowing test and a full clinical evaluation of the cranial nerves involved in swallowing. In patients with SD on the first test, a second test was done within 48 h in order to discriminate between transient and persistent SD. Results Among the 482 patients mechanically ventilated more than 7 days, 138 were enrolled in this study. The first test performed 24 h after extubation revealed SD in 35 patients (25%). According to the second test performed 48 h later, SD were considered transient in 21 (15%) and persistent in 14 (10%) cases. Patients with persistent SD were older (66 ± 16 vs 58 ± 15 years), had lower bodyweight at admission (76 ± 15 vs 87 ± 23 kg) and received less often neuromuscular blocking agents (36% vs 66%) compared to patients without or with only transient SD. Patients with persistent SD had longer duration of Intensive Care Unit (ICU) stay after first extubation and longer delay to oral feeding than patients without or with only transient SD, respectively, 11 ± 9 vs 7 ± 6 days and 23 ± 33 vs 5 ± 7 days. Conclusions Based on a specific standardized clinical test, 25% of patients mechanically ventilated more than 7 days exhibited clinical manifestations of SD. However, SD were considered as persistent after extubation in only 10% of them. Persistent SD were associated with longer duration of ICU stay after extubation and longer time of enteral feeding. Trial registration: The study is registered with Clinical Trials (NCT01360580).