Swallowing Function After Pioneering Partial Face and Whole Eye Transplant: Clinical Insights.

Abstract

Purpose: There is limited literature reporting swallowing outcomes in the pre- and postoperative period for patients undergoing facial transplantation. This case report aims to utilize a combination of objective and patient-reported outcome measures to highlight swallowing improvements following the world's first face with whole-eye transplantation.

Method: Outcome measures in jaw range of motion, anterior containment, texture progression, airway protection, and pharyngeal swallow function were collected pre-transplantation by two speech-language pathologists (SLPs) and at multiple postoperative visits after the procedure was completed. Specific outcome measures included the Gothenburg Trismus Questionnaire, Maximal Incisor Opening, Modified Teachers Drooling Scale, Functional Oral Intake Scale, Eating Assessment Tool-10, The Penetration-Aspiration Scale, and the Modified Barium Swallow Study Impairment Profile. Measures were then compared over a 1-year time period to assess changes in swallow function.

Results: Improvements in jaw range of motion, anterior containment, and airway protection were observed. The patient's stated goal of returning to full PO diet following face transplant was achieved within 1 year.

Conclusions: Swallowing and trismus outcome measures are an important tool for monitoring progress along a patient's recovery journey, especially following unique procedures such as face transplantation. Based on this single patient case study, facial transplantation can lead to improvements in both objective and patient-reported outcomes. Future goals for research should continue to explore this unique population due to the limited literature available for SLPs, as well as include development of valid and reliable assessment tools specific to the face transplantation population.