Evaluation and Outcomes of Iatrogenic Oropharyngeal Dysphagia

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-04-14 DOI:10.1111/coa.14315

Shorook Naara, Shadi Shinnawi, Nadeem Habashi, Eli Rimmer, Salem Billan, Jacob T. Cohen

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引用次数: 0

Abstract

Objective

To investigate the outcomes of iatrogenic oropharyngeal dysphagia and compare them with outcomes from different types of dysphagia aetiologies.

Study Design

Retrospective analysis.

Setting

This study was conducted on patients evaluated at a tertiary hospital's Swallowing Disorder Center using physical examination and fibreoptic endoscopic evaluation of swallowing (FEES) between January 2015 and October 2021.

Methods

Patients were divided into six groups according to the potential cause of dysphagia: (1) Post head and neck cancers (HNCs) treatment; (2) Post-surgery for non-cancerous aetiology; (3) Neurological; (4) Intracranial; (5) Head and neck pathology; and (6) Others. Of these, the first and second groups comprise dysphagia caused by treatment (iatrogenic dysphagia). FEES results were analysed using the Swallowing Performance Status Scale (SPSS) and the Penetration Aspiration Scale (PAS).

Results

Of the 507 patients included, 146 (28.8%) had iatrogenic dysphagia, and 361 (71.2%) had non-iatrogenic dysphagia. After swallowing therapy, 138 patients underwent a follow-up FEES examination (47 patients with iatrogenic dysphagia and 91 patients with non-iatrogenic dysphagia). After swallowing intervention (compensatory technique and food consistency changes), the follow-up FEES examination revealed significant improvement in the non-iatrogenic group (p < 0.001), while the iatrogenic group showed no significant improvement after intervention. PAS and SPSS scores also demonstrated greater improvement in the non-iatrogenic group.

Conclusions

This study emphasises that iatrogenic dysphagia is a common entity in the swallowing disorders outpatient ENT clinic. It is more likely to persist and resist conventional swallowing therapy, leading to worse outcomes compared to non-iatrogenic dysphagia.

查看原文本刊更多论文

医源性口咽吞咽困难的评价和预后。

目的：探讨医源性口咽吞咽困难的预后，并与不同类型咽咽吞咽困难病因的预后进行比较。研究设计：回顾性分析。背景：本研究于2015年1月至2021年10月在某三级医院吞咽障碍中心接受体格检查和纤维内镜吞咽评估（FEES）的患者进行。方法：根据患者发生吞咽困难的可能原因分为6组：(1)头颈癌（HNCs）治疗后患者；(2)术后非癌性病因；(3)神经;(4)颅内;(5)头颈部病理；（六）其他。其中，第一组和第二组包括治疗引起的吞咽困难（医源性吞咽困难）。使用吞咽行为状态量表（SPSS）和渗透吸入量表（PAS）对费用结果进行分析。结果：507例患者中，146例（28.8%）为医源性吞咽困难，361例（71.2%）为非医源性吞咽困难。吞咽治疗后，138例患者接受了随访FEES检查（47例医源性吞咽困难，91例非医源性吞咽困难）。吞咽干预（代偿技术和食物稠度改变）后，随访的FEES检查显示非医源性组有显著改善(p)。结论：本研究强调医源性吞咽困难是门诊耳鼻喉科吞咽障碍患者的常见症状。与非医源性吞咽困难相比，它更有可能持续存在并抵抗常规吞咽治疗，导致更糟糕的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.