{"title":"Association Between Phase Angle and Tongue Pressure in Older Inpatients with Connective Tissue Diseases.","authors":"Toshiyuki Moriyama, Mizuki Tokunaga, Ryoko Hori, Akiko Hachisuka, Hideaki Itoh, Mitsuhiro Ochi, Yasuyuki Matsushima, Satoru Saeki","doi":"10.1007/s00455-025-10806-6","DOIUrl":"10.1007/s00455-025-10806-6","url":null,"abstract":"<p><p>To investigate the association between tongue pressure (TP) and phase angle (PhA) in patients with connective tissue diseases (CTDs) aged 65 years or older. This retrospective cross-sectional study was conducted on 189 patients with CTDs who underwent hospital rehabilitation. TP was measured using a tongue pressure measuring device, and PhA was calculated from the bioimpedance analysis readings. Statistical analyses included multivariate linear regression with TP and receiver operating characteristic curves to determine PhA cutoff values indicative of low TP, defined as < 24.3 kPa for men and < 23.7 kPa for women. A total of 189 patients with CTDs (mean age 75 years; 49 men and 140 women; mean PhA 4.0°; mean TP 27.7 kPa) were included in the analysis. Fifty-five patients had low TP. Patients with low TP had lower PhA values than those with normal TP (mean PhA values 3.5° versus 4.3°). After adjusting for confounding factors, PhA (β = 0.387, p < 0.001) was significantly associated with TP. Cutoff values for PhA predicting low TP were identified as 3.9° for men and 3.5° for women. PhA is associated with TP, independent of other factors, in older inpatients with CTDs. The identified PhA cutoff values could enable the early detection of declining TP.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1105-1112"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictors of Pneumonia in Patients With Penetration-Aspirations Detected on Fiberoptic Endoscopic Evaluation of Swallowing.","authors":"Raviv Allon, Elad Babayof, Yonatan Lahav, Yael Shapira-Galitz","doi":"10.1007/s00455-025-10817-3","DOIUrl":"10.1007/s00455-025-10817-3","url":null,"abstract":"<p><p>Aspiration pneumonia is a serious condition resulting from swallowing dysfunction. However, predicting high risk patients remains challenging. This study aimed to assess the incidence and risk factors for pneumonia in oropharyngeal dysphagia patients exhibiting episodes of penetration or aspiration during fiberoptic endoscopic swallowing evaluation (FEES). A retrospective analysis was performed on patients who visited a dysphagia clinic between 2016 and 2022, and demonstrated at least one episode of penetration or aspiration during the FEES (Penetration Aspiration Scale [PAS] score ≥ 3). Data collected included demographics, comorbidities and FEES findings. Outcomes included mortality, hospital admissions to treat pneumonia events, and incidents of pneumonia managed by primary care providers or outpatient medical facilities. Statistical analyses included descriptive statistics, chi-squared tests, t-tests, logistic regression and Kaplan-Meier survival analysis. Among 73 patients (mean follow-up: 3.87 ± 1.5 years), 33 (45.2%) exhibited penetration, and 40 (54.8%) aspiration. Pneumonia developed in 41 patients (56%), with 33 (45%) hospitalized. A total of 28 patients (38.4%) died during follow-up. A history of prior pneumonia (OR: 1.374, p = 0.02) and Murray Secretion Scale score (OR: 1.121, p = 0.022) were associated with subsequent pneumonia events. Reduced laryngeal sensation showed a near-significant trend toward association with pneumonia-related hospitalizations in the penetration group (58.3% vs. 19%, P = 0.052). No significant association was found between PAS and pneumonia or mortality. Prior pneumonia and secretions accumulation during FEES significantly predict pneumonia in patients presenting with penetration-aspiration during FEES. Reduced laryngeal sensation showed a nearly-significant trend toward pneumonia-related hospitalizations.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1205-1213"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-03-28DOI: 10.1007/s00455-025-10823-5
Tyler W Crosby, Sonja Molfenter, Matina Balou, Uche C Ezeh, Milan R Amin
{"title":"The Efficacy of Outpatient Swallowing Therapy: A Retrospective Longitudinal Cohort Study.","authors":"Tyler W Crosby, Sonja Molfenter, Matina Balou, Uche C Ezeh, Milan R Amin","doi":"10.1007/s00455-025-10823-5","DOIUrl":"10.1007/s00455-025-10823-5","url":null,"abstract":"<p><p>Oropharyngeal dysphagia is an independent predictor of poor outcomes in many health conditions and can be targeted directly through swallowing therapy. This study aims to explore the outcomes of outpatient swallowing therapy in clinical practice across a diverse cohort of patients. This was a retrospective, single-site longitudinal cohort study. Patients 18 years or older with dysphagia who completed 7-8 weeks of outpatient swallowing therapy with a pre- and post-treatment videofluoroscopy were included. Therapy employed a progressive swallowing exercise regimen based on the Systematic Exercise for Treatment of Swallowing (SETS) protocol. Outcome measures included the pharyngeal components of the Modified Barium Swallow Impairment Profile, penetration-aspiration scale scores, and diet recommendations using the International Dysphagia Diet Standardization Initiative. 152 patients were included. Swallowing therapy improved all MBSImP component scores except 1, 7, and 13. Therapy improved total pharyngeal impairment scores by 2.66 points (p < .001) and total oral impairment score by 1.41 points (p < .001). Odds of elevated aspiration risk were reduced by 49% (p < .001). Patients were more likely to be on an unmodified food consistency after completion of therapy (OR 26, p = .004), but liquid consistency was not altered (OR 2.0, p = .57). Overall, 44% of patients in the cohort with an efficiency issue improved, and 50% of patients at risk for aspiration pre-therapy improved. Completing a 7-8 week course of exercise-based outpatient swallowing therapy is effective at improving multiple measures of swallowing physiology, safety and efficiency. It can also enable relaxation of diet consistency restrictions based on the IDDSI framework.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1250-1262"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-02-05DOI: 10.1007/s00455-025-10805-7
Sabrina A Eltringham, Nicola Martindale, Elizabeth Lightbody, Sue Pownall, Andrew Booth, Craig J Smith
{"title":"Barriers and Facilitators to implementation of the Free Water Protocol in the Acute Stroke Unit Setting: A Mixed Methods Systematic Review.","authors":"Sabrina A Eltringham, Nicola Martindale, Elizabeth Lightbody, Sue Pownall, Andrew Booth, Craig J Smith","doi":"10.1007/s00455-025-10805-7","DOIUrl":"10.1007/s00455-025-10805-7","url":null,"abstract":"<p><p>Free water protocols (FWP) give patients at risk of aspiration the option to drink water between meals. Evidence is lacking about their use in acute stroke care. This systematic review evaluated the literature about barriers and facilitators to FWP implementation in acute stroke unit settings. Electronic databases and grey literature sources were systematically searched, eligible studies were critically appraised, and data extracted and mapped onto the Consolidated Framework for Implementation Research (CFIR). The results are presented in a narrative synthesis. Five studies were identified for inclusion: Two qualitative studies, 1 mixed method study, 1 randomised controlled trial and 1 pilot cohort study. Barriers and facilitators to implementation were identified across the 5 CFIR domains. Key barriers were a lack of evidence base and a standard protocol, trying to adapt and deliver a protocol designed for a different setting, complexity of patient selection and FWP design, culture of risk aversion, nursing staff availability and skills to deliver the FWP, and a greater use of agency nurses and transient workforce. Key facilitators were the existence of national guidance for research into its use, implementation of oral care protocols prior to FWP implementation, the unique characteristics of the acute stroke setting, leadership and modelling by senior clinicians, interdisciplinary working and accountability for roles and responsibilities for each discipline, regular communication and ongoing education, and involving patients in decision making and implementation. The findings of this review will guide the data collection of a feasibility study of the FWP in acute stroke.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1023-1034"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-02-26DOI: 10.1007/s00455-025-10818-2
Cara Donohue
{"title":"Motor Imagery Practice to Improve Respiratory and Cough Function.","authors":"Cara Donohue","doi":"10.1007/s00455-025-10818-2","DOIUrl":"10.1007/s00455-025-10818-2","url":null,"abstract":"<p><p>Motor imagery practice (MP), or visualizing performing a task without executing it, is an effective intervention for the limbs and tongue. However, MP of expiratory muscle strength training (EMST) and voluntary cough (VC) has not been explored. We examined the feasibility and impact of MP of VC and EMST on pulmonary and cough function in twenty community-dwelling adults. Participants underwent two baseline research evaluations of maximum expiratory and inspiratory pressure (MEP, MIP), forced vital capacity (FVC), voluntary peak expiratory flow rate (PEF), and cough spirometry. After the second research evaluation, participants underwent five weeks of MP of VC or EMST (alternating assignment, 25 repetitions, 70% training load, daily) at home with weekly telehealth sessions. Participants underwent post-treatment research evaluations of MEP, MIP, FVC, PEF, cough spirometry, and the Exercise Therapy Burden Questionnaire (ETBQ). Treatment adherence and telehealth attendance were tracked. Descriptives and Wilcoxon signed rank tests were performed. MP adherence was 95% and telehealth attendance was 91%. Median (IQR) ETBQ scores were 8 (1, 15), indicating minimal burden. Across both MP groups, increases in PEF from a handheld device (+ 13.7, 95% CI: 1.8, 25.6, p = 0.03) and from cough spirometry (+ 0.71, 95% CI: 0.05, 1.4, p = 0.04) were observed. Increases in PEF from cough spirometry (+ 1.00, 95% CI: 0.12, 1.9, p = 0.04) were observed for the MP VC group. Preliminary data demonstrate MP of VC and EMST is feasible and improves voluntary cough in community-dwelling adults. Future research is needed in larger sample sizes and patient populations with pulmonary, cough, and swallowing impairments.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1214-1227"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-02-28DOI: 10.1007/s00455-025-10814-6
Gabriella Le Blanc, Jennifer Silver, Ninell Sygal, Nicolas Pilote, Karen M Kost, Marco A Mascarella, Nader Sadeghi
{"title":"Validation of a Cross-Cultural Adaptation of the M.D. Anderson Dysphagia Inventory to Canadian French (MDADI-CF).","authors":"Gabriella Le Blanc, Jennifer Silver, Ninell Sygal, Nicolas Pilote, Karen M Kost, Marco A Mascarella, Nader Sadeghi","doi":"10.1007/s00455-025-10814-6","DOIUrl":"10.1007/s00455-025-10814-6","url":null,"abstract":"<p><p>The MDADI is a validated tool for assessing quality of life in several languages, often used for patients with head and neck cancer (HNC). It has never been translated and validated in Canadian French, which bears significantly different linguistic characteristics compared to European French. Our objective was to validate a Canadian French version of the MDADI (MDADI-CF) for HNC patients suffering from dysphagia. The MDADI-CF was developed using the translation-back-translation method. Participants were recruited from an outpatient clinic: those suffering from dysphagia secondary to HNC comprised the experimental group, while those without dysphagia comprised the control group. They were asked to complete the MDADI-CF and the SWAL-QoL, another similar questionnaire on dysphagia which has been validated in French. A subgroup of patients also received a second MDADI-CF to complete one week later. Feasibility, internal consistency, construct validity, and test-retest reliability were all assessed. 93% of patients completed the questionnaire without leaving any questions blank. Internal consistency analyses demonstrated a Cronbach's alpha > 0.7 for all subscales of the questionnaire. Convergent validity was confirmed with a high correlation between the MDADI-CF scores and French SWAL-QOL (0.91, p < 0.0001). Discriminant validity was also demonstrated by the significant difference between MDADI-CF scores of patient vs control group (93.3 vs 62.4, p < 0.0001). Test-retest reliability was demonstrated with an intraclass correlation coefficient of 0.918 on the total score between the first and second questionnaire completion. Our results demonstrate that the MDADI-CF I is valid and should be used in evaluating dysphagia in the Canadian Francophone population.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1176-1183"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-03-05DOI: 10.1007/s00455-025-10810-w
Ahmed Mohamed Zayed, Omayma Afsah, Tamer Elhadidy, Tamer Abou-Elsaad
{"title":"Swallowing Evaluation in Post-COVID-19 Patients with Oropharyngeal Dysphagia.","authors":"Ahmed Mohamed Zayed, Omayma Afsah, Tamer Elhadidy, Tamer Abou-Elsaad","doi":"10.1007/s00455-025-10810-w","DOIUrl":"10.1007/s00455-025-10810-w","url":null,"abstract":"<p><p>Oropharyngeal dysphagia (OD) is a prevalent issue in hospitalized COVID-19 patients. This study aimed to determine swallowing abnormalities in post-COVID-19 patients with OD and to determine the potential risk factors of aspiration in patients who have recovered from COVID-19. Screening for OD was done for 310 patients who were discharged from the main university isolation hospital during the study period. A longitudinal descriptive study was carried out on 127 adult post-COVID-19 patients between the ages of 24 and 65 years who failed OD screening at the time of discharge. Instrumental swallowing assessment was done using fiberoptic endoscopic evaluation of swallowing (FEES) at one of two different time points: one-week post-discharge (Group 1) and 3-4 weeks post-discharge (group 2). The prominent swallowing abnormalities were delayed triggering of swallowing reflex, laryngeal penetration, tracheal aspiration, as well as vallecular and pyriform sinuses residue with lower frequencies and milder degrees in group 2 than in group 1 patients. Statistically significant associations were found between the presence of ageusia and anosmia in post-COVID-19 patients and both impaired laryngeal sensation and delayed triggering of the swallowing reflex. Significant associations were detected between aspiration in post-COVID-19 patients and the following factors: higher Eating Assessment Tool (EAT-10) scores, presence of dysphonia, higher respiratory rate, and the longer duration of the use of noninvasive ventilation (NIV) and/or invasive mechanical ventilation (IMV). The combined higher EAT-10 scores and higher respiratory rate predicted aspiration in post-COVID-19 patients by an overall percentage of 87.1.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1145-1155"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-03-29DOI: 10.1007/s00455-025-10822-6
Brinda R Korivi, Carla L Warneke, Mostafa A Shehata, Sheila Buoy, Xiaohui Tang, Madhavi Patnana, Sarah M Palmquist, Sanaz Javadi, Sonia Prithvi Rao, Ronald A Rauch, Mindy X Wang, Khaled M Elsayes, Katherine A Hutcheson
{"title":"Fluoroscopy Time of Radiologist-Monitored Modified Barium Swallow Exams in Oncology: A 3-year Single Institution Retrospective Study.","authors":"Brinda R Korivi, Carla L Warneke, Mostafa A Shehata, Sheila Buoy, Xiaohui Tang, Madhavi Patnana, Sarah M Palmquist, Sanaz Javadi, Sonia Prithvi Rao, Ronald A Rauch, Mindy X Wang, Khaled M Elsayes, Katherine A Hutcheson","doi":"10.1007/s00455-025-10822-6","DOIUrl":"10.1007/s00455-025-10822-6","url":null,"abstract":"<p><p>Fluoroscopy time is an important metric for radiation safety, but how it is related to dysphagia severity as graded by Dynamic Grade of Swallowing Toxicity (DIGEST) criteria and other factors in oncology practice is undocumented. We evaluated the fluoroscopy time for the bolus protocol used at the originating institution of the DIGEST method and assessed the relationship between fluoroscopy time and DIGEST grade, exam indication, and additional parameters. Eleven trials, including specified VARIBAR® barium volumes, were included in the standard bolus protocol. Electronic health record (EHR) 2018-2021 databases were sampled in a retrospective STARI-guided DIGEST implementation evaluation for clinically reported DIGEST grades in the EHR and matched to fluoroscopy time. The study sample included 4,162 modified barium swallow (MBS) examinations. Using generalized linear modeling, we tested log-transformed fluoroscopy time associations with Tukey's adjustment for multiple pairwise comparisons. MBS duration ranged from 0.16 to 11.80 min (Median 2.21, IQR 1.98). Fluoroscopy time was associated with exam indication, cancer diagnosis, setting, and DIGEST grade. Fluoroscopy times increased as the DIGEST severity grade worsened (R<sup>2</sup> = 0.45, p < .0001). MBS indication was also associated with fluoroscopy time (R<sup>2</sup> = 0.12, p < .0001), with the shortest times for baseline exams and the longest for excluding leaks (Median1.6 vs. 3.5 min). Median fluoroscopy time was shorter among endocrine and metastatic cancer patients and longer among head and neck cancer patients (2 vs. 3 min, R<sup>2</sup> = 0.02, p < .0001). Inpatient examinations were longer than outpatient (Median 3.1 vs. 2.2 min, R<sup>2</sup> = 0.02, p < .0001). The bolus protocol was clinically acceptable within ALARA standards. Clinicians should be mindful of increased fluoroscopy time and optimize exams as clinically indicated in patients with severe dysphagia, leak exclusion, and inpatient studies.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1240-1249"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of the Swallowing Function After Reconstruction of Cervical Esophagus with Jejunum, Ileocolon or Skin Flap: Method of Physiotherapy for Deglution and Long Term Follow-Up.","authors":"Katie Kai-Yuan Lin, Hung-Chi Chen, Shih-Heng Chen, Chi-Wen Huang","doi":"10.1007/s00455-025-10813-7","DOIUrl":"10.1007/s00455-025-10813-7","url":null,"abstract":"<p><p>The swallowing function is a major goal of reconstruction for the patients who had hypopharyngeal cancer and received total pharyngolaryngectomy with or without voice reconstruction. We would like to share our experience in reconstruction of swallowing function using jejunum, ileocolon, or anterolateral thigh flap for cervical esophagus. In this study, we proposed that the jejunum flap is the most suitable option for restoring swallowing function, owing to its physiological characteristics. A retrospective study was conducted in 36 patients undergoing reconstruction of cervical esophagus with free jejunum flap (7 cases), ileocolon flap (21 cases), or anterolateral flap (8 cases). Esophagography, time required to achieve swallowing of semisolid diet without tube feeding, changes in body weight before and after the surgery, and <sup>99m</sup>Tc for transit scan to evaluate pharyngeal clearance were used to evaluate the swallowing function of the patients. Patients with jejunum flap had the best swallowing function, followed by ileocolon and then ALT flap. Besides, no conduits needed to be modified in jejunum and ileocolon flap. Regarding swallowing function, for patients with longer life expectancy and no contraindication of laparotomy, jejunum flap should be the first choice to obtain optimal swallowing function for cervical esophagus. Anterolateral flap is the easiest and most commonly used flap and provides fair swallowing function if there is no leakage. However, the anterolateral thigh flap tends to develop narrowing on long-term following-up. Based on completeness of pharyngeal transit of bolus and lack of complications, patients with jejunal flap reconstruction showed best swallowing function, followed by ileocolon and then ALT flaps.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1163-1175"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-10-01Epub Date: 2025-02-13DOI: 10.1007/s00455-024-10801-3
J Hötzel, E Zaretsky, A Goeze, C Hey
{"title":"Predictive Power of Pharyngolaryngeal Secretion Accumulations for Penetration and Aspiration in Head and Neck Cancer Patients.","authors":"J Hötzel, E Zaretsky, A Goeze, C Hey","doi":"10.1007/s00455-024-10801-3","DOIUrl":"10.1007/s00455-024-10801-3","url":null,"abstract":"<p><p>Pharyngolaryngeal secretions, penetration, and aspiration belong to the cardinal symptoms of swallowing disorders in head and neck cancer patients. In order to provide safe swallowing diagnostics, it is of interest whether pharyngolaryngeal secretion accumulations can be used as a predictor for penetration and aspiration of food and liquids. This study analyzed the predictive power of pharyngolaryngeal secretion accumulations for the penetration and aspiration in head and neck cancer patients. Between 2016 - 2024, 403 head and neck cancer patients underwent swallowing diagnostics via Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Pharyngolaryngeal secretions were graded with the secretion severity rating scale (SSRS) by Murray et al., penetration and aspiration with the penetration-aspiration scale (PAS) by Rosenbek et al. Both scales were cross-tabulated and correlated with each other. Possible influencing factors on PAS were analyzed by Spearman's correlations and Kruskal-Wallis-H-tests: patients' age, tumor stage and site, type of the oncological therapy, and time of examination. A linear regression and a Categorical Principal Components Analysis were utilized for the same purpose. Higher SSRS and PAS values tended to co-occur. In univariate calculations, the tumor stage and time of examination showed significant correlations with PAS. In multivariate analyses, the tumor stage, patients' age, but above all the SSRS were shown to be significant influencing factors on PAS. Pharyngolaryngeal secretion accumulations can be used for the prediction of aspiration of food and liquids and thus for the improvement of safety of the swallowing diagnostics via FEES.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"1055-1063"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}