Laryngeal Penetration and Aspiration Among Patients With Oropharyngeal and Oesophageal Dysphagia: A Meta-Analysis and Moderator Analysis

IF 4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-07-24 DOI:10.1111/joor.70021

Alfiani Rahmi Putri, Yu-Hao Chu, Hidayat Arifin, Kondwani Joseph Banda, Chien-Mei Sung, Jia-You Ye, Ruey Chen, Pi-Yu Su, Kuei-Ru Chou

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引用次数: 0

Abstract

Background

Laryngeal penetration and aspiration are major global health concerns, especially in patients with dysphagia. Despite their serious impact, previous meta-analyses evaluating their overall prevalence remain limited.

Objective

To estimate the prevalence of laryngeal penetration and aspiration in patients with oropharyngeal and oesophageal dysphagia.

Materials and Methods

A comprehensive search of seven databases (Embase, Scopus, Web of Science, PubMed, CINAHL and ProQuest) was conducted without restriction by region, language, or publication date. A generalised linear mixed model and random-effects model were used to calculate pooled prevalence estimates. Moderator analyses were performed to explore potential sources of heterogeneity. All statistical analyses were conducted using R software.

Results

A total of 46 studies involving 5535 patients with dysphagia across 19 countries were included. The pooled prevalence of laryngeal penetration was 48.5%, highest among those with oropharyngeal dysphagia and in North America. Aspiration prevalence was 30.0%, highest in Europe. The prevalence of laryngeal penetration and aspiration was between 49.3% and 29.4%, respectively, in patients with oropharyngeal dysphagia and 31.5% and 12.6%, respectively, in those with oesophageal dysphagia. Significant moderators included hospital setting, male sex, oropharyngeal dysphagia, dysphagia aetiology, pharyngeal reflex delay, dysfunction of the vallecula and pyriform sinuses, impaired laryngeal closure, oral residue, oral feeding, laryngotracheal aspiration, silent aspiration and current smoking.

Conclusions

Laryngeal penetration and aspiration are highly prevalent in dysphagia, particularly in oropharyngeal dysphagia. Early identification of risk factors and targeted interventions are critical to minimising complications and enhancing patient outcomes.

Clinical Significance

Understanding high prevalence and key moderators of laryngeal penetration and aspiration in dysphagia, especially oropharyngeal types, underscores the need for proactive screening and personalised management to prevent laryngeal penetration and aspiration-related complications and improve quality of care.

Abstract Image

查看原文本刊更多论文

口咽和食管吞咽困难患者的喉穿入和吸入：一项荟萃分析和调节分析。

背景：喉部穿透和吸入是全球主要的健康问题，特别是在吞咽困难患者中。尽管其影响严重，但先前评估其总体流行程度的荟萃分析仍然有限。目的：了解口咽及食管吞咽困难患者喉穿吸的发生率。材料和方法：全面检索Embase、Scopus、Web of Science、PubMed、CINAHL和ProQuest 7个数据库，不受地区、语言和出版日期的限制。采用广义线性混合模型和随机效应模型计算合并患病率估计值。进行调节分析以探索异质性的潜在来源。所有统计分析均采用R软件进行。结果：共纳入46项研究，涉及19个国家的5535例吞咽困难患者。喉部穿透的总患病率为48.5%，在口咽吞咽困难患者和北美地区最高。吸入患病率为30.0%，在欧洲最高。口咽吞咽困难患者喉穿入和误吸的发生率分别为49.3%和29.4%，食管吞咽困难患者分别为31.5%和12.6%。显著调节因素包括医院环境、男性、口咽吞咽困难、吞咽困难病因、咽反射延迟、小静脉和梨状窦功能障碍、喉闭受损、口腔残留、口服喂养、喉气管误吸、无声误吸和吸烟。结论：喉穿入和误吸在吞咽困难中非常普遍，尤其是口咽部吞咽困难。早期识别风险因素和有针对性的干预措施对于最大限度地减少并发症和提高患者预后至关重要。临床意义：了解吞咽困难，特别是口咽部类型喉部穿透和吸入的高患病率和关键调节因素，强调需要进行主动筛查和个性化管理，以预防喉部穿透和吸入相关并发症，提高护理质量。

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

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.