Dysphagia最新文献

{"title":"Dysphagia and Oral Health in Older Adults: Examining Demographic and Clinical Associations.","authors":"Heather Warner, Shawneen Buckley, Victoria A Zigmont, Joan Arsenault","doi":"10.1007/s00455-026-11007-5","DOIUrl":"https://doi.org/10.1007/s00455-026-11007-5","url":null,"abstract":"<p><p>Oral health is a modifiable risk factor with significant implications for general health, particularly in the geriatric patient population. Poor oral hygiene has been linked to respiratory disease, aspiration pneumonia, and systemic conditions such as diabetes and cardiovascular disease. Oral health is a critical component of clinical care for elderly patients with dysphagia; however, limited literature exists to guide clinicians in describing the patient characteristics associated with inadequate oral health in this population. This retrospective study aimed to identify associations between patient characteristics and inadequate oral health in a geriatric population with dysphagia. Data were collected from 29,302 patients aged 65 and older referred to a regional mobile medical practice providing MBSS services across multiple residential and health care settings in the northeastern United States between 2013 and 2019. Inadequate oral health was coded as a binary variable based on documented findings related to oral secretions, oral hygiene, mucosa, and dentition. A multivariable logistic regression model was used to analyze the relationship between oral health status and both demographic and clinical factors. The multivariable regression analysis included 18,395 complete cases. Results indicated that the demographic variables significantly associated with inadequate oral health included being male (AOR = 1.21; 95% CI: 1.12, 1.31), Black (AOR = 1.42, 95% CI = 1.15, 1.76), and residing in a skilled nursing facility (AOR = 1.17, 95% CI: 1.02, 1.35). Observed disparities may reflect inequities in access to oral healthcare and other structural factors rather than inherent patient characteristics. Clinical characteristics associated with inadequate oral health included moderate-to-severe (AOR = 3.05, 95% CI: 1.83, 5.06), severe oral dysphagia (AOR = 3.98, 95% CI: 2.35, 6.75), profound pharyngeal dysphagia (AOR = 1.92, 95% CI: 1.14, 3.23), non-ambulatory status (wheelchair AOR = 1.47, 95% CI: 1.19, 1.82); chair/bed bound AOR = 1.34, 95% CI: 1.07, 1.67)) dependence for feeding (required assistance AOR = 1.45, 95% CI: 1.30, 1.61; dependent for feeding AOR = 1.44, 95% CI: 1.22, 1.71), and dietary modifications (IDDSI 3 AOR = 1.29, 95% CI: 1.13, 1.47; IDDSI 4 AOR = 1.27, 95% CI: 1.14, 1.43; IDDSI 5 AOR = 1.19, 95% CI: 1.06, 1.34; IDDSI 6 AOR = 1.17, 95% CI: 1.06, 1.31). Among dietary categories, patients classified as nil per os (NPO) had the highest odds of inadequate oral health (AOR = 2.03, 95% CI: 1.62, 2.53). The study identified demographic and clinical characteristics associated with inadequate oral health in this geriatric dysphagia population, offering a first step in guiding preventive efforts, institutional protocols, and interdisciplinary approaches to oral health management.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105702","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":"Correction to: A Rare Vascular Cause of Dysphagia.","authors":"Fahmi Shibli, Amir Mari, Amir Farah","doi":"10.1007/s00455-026-11006-6","DOIUrl":"10.1007/s00455-026-11006-6","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059348","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":"Nasogastric Tubes and Hinoki Aroma: Opposing Modulators of Premotor Swallow Load? A Commentary on Two 2026 Dysphagia Studies.","authors":"Huan Du, Minzhi Yang, Qianqian Wang, Qian Yang, Wenting Zhao","doi":"10.1007/s00455-026-11009-3","DOIUrl":"https://doi.org/10.1007/s00455-026-11009-3","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030096","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":"Nicergoline for Neuromuscular Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled Randomized Trial.","authors":"Pittayut Wongwarawanith, Phawin Keskool, Sunun Ongard, Sasalaksamon Chanachai, Jitima Jariyakhunphanya","doi":"10.1007/s00455-026-11003-9","DOIUrl":"https://doi.org/10.1007/s00455-026-11003-9","url":null,"abstract":"<p><p>Neuromuscular oropharyngeal dysphagia impairs the coordinated neurologic and muscular mechanisms of deglutition, predisposing patients to aspiration pneumonia, malnutrition, and diminished quality of life. Substance P participates in the swallow reflex; nicergoline, an ergot derivative, increases substance P concentrations, yet its therapeutic effect on dysphagia remains uncertain. We conducted a double-blind, randomized, placebo-controlled trial to determine whether nicergoline improves swallow function, quantified by the visual analog scale and flexible endoscopic evaluation of swallowing. Forty-four patients with neuromuscular oropharyngeal dysphagia were randomized to receive nicergoline 30 mg daily (n = 21) or matched placebo (n = 23) for 4 weeks. Baseline and week-4 visual analog scale scores, flexible endoscopic evaluation of swallowing scores, and penetration-aspiration scale ratings were compared within and between groups. Thirty-eight participants completed the study (nicergoline n = 19; placebo n = 19). Changes in visual analog scale and flexible endoscopic evaluation scores did not differ significantly between groups. However, nicergoline produced a statistically significant reduction in penetration-aspiration scale score, indicating enhanced airway protection during swallowing. These data suggest that nicergoline augments swallow safety in neuromuscular oropharyngeal dysphagia and may offer a therapeutic option for its management.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982483","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":"Oral Intake Recovery in Non-Intubated Patients With COVID-19 Pneumonia Compared With Non-COVID Pneumonia: A Retrospective Cohort Study Using the Functional Oral Intake Scale.","authors":"Shinichi Watanabe, Takaaki Sakurai, Takahiro Kanaya, Takumi Iwasaki, Hyosuke Oshima, Tetsuya Furukawa, Tomohiro Yoshikawa, Seichi Nakahashi, Yasunari Morita","doi":"10.1007/s00455-026-11002-w","DOIUrl":"https://doi.org/10.1007/s00455-026-11002-w","url":null,"abstract":"<p><p>Dysphagia is a complication of coronavirus disease 2019 (COVID-19), often attributed to intubation and critical illness. However, the recovery trajectory in non-intubated patients with COVID-19 compared with that in patients with other pneumonia types remains unclear. This retrospective cohort study included non-intubated adults hospitalized with pneumonia between May 2022 and December 2023, comparing COVID-19 and non-COVID pneumonia patients regarding time to functional oral intake (Functional Oral Intake Scale [FOIS] ≥ 4) and longitudinal FOIS changes. Two Cox proportional hazards models were fitted: Model 1 estimated the total effect (pre-exposure variables only), and Model 2 estimated a conditional association after further adjustment for post-exposure rehabilitation variables. A linear mixed-effects model was used for the longitudinal analysis. Of the 431 patients (168 COVID-19, 263 non-COVID), the COVID-19 group had significantly delayed initiation of oral intake and speech therapy. In Model 1, COVID-19 was associated with a 44% lower hazard of achieving FOIS ≥ 4 (HR 0.56; 95% CI, 0.42-0.76; p = 0.0001). In Model 2, this attenuated to null (HR 1.03; 95% CI, 0.73-1.46; p = 0.876), and a time-dependent Cox sensitivity analysis was concordant (HR 0.88; 95% CI, 0.63-1.23; p = 0.465). Higher pre-hospital frailty, delayed oral intake, and lack of direct swallowing training independently predicted slower recovery. These findings indicate that the slower recovery observed in patients with COVID-19 was largely attributable to delays in oral intake and rehabilitation rather than to COVID-19 itself, supporting early oral intake and equitable direct swallowing training under infection control constraints.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944460","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":"The Effect of Carbonated Liquid on Swallowing Safety of People with Parkinson Disease (DYSparkLE): A Prospective Within-Subject, Repeated-Measures Observational Study.","authors":"J Glinzer, J-C Koseki, A Niessen, J Zang, J C Nienstedt, C Buhmann, C Pflug","doi":"10.1007/s00455-026-11005-7","DOIUrl":"https://doi.org/10.1007/s00455-026-11005-7","url":null,"abstract":"<p><p>Impaired swallowing safety with thin liquids is a concern in patients with Parkinson disease (PwPD). Sensory stimulation is frequently used in dysphagia rehabilitation. Previous studies suggest that carbonated liquid (CL) has beneficial effects on swallowing function. The objective of this study is to evaluate how drinking CL influences swallowing safety in PwPD. PwPD were consecutively recruited at our Parkinson day-clinic from July 2023 to July 2024. Patients with atypical or secondary Parkinsonism and other neurological or oncological diseases also causing dysphagia were excluded. Swallowing was assessed using flexible-endoscopic evaluation of swallowing (FEES). The assessment protocol included 5 and 90 mL of unflavored non-carbonated liquid (nCL) and CL. The primary outcome was the depth of airway invasion (DAI) with 90 mL. 83 PwPD (25 women) were included (age: 67.8±9.4 years; UPDRS III (Unified Parkinson's Disease Rating Scale, Part III): 34.9±14.3 points; disease duration: 7.9±5.9 years). Multilevel logistic regression showed that with CL, the odds of an airway invasion are significantly reduced compared to nCL. A second, exploratory subgroup analysis using binary logistic regression showed that the odds for PwPD to benefit from CL are higher for those reporting fewer dysphagia symptoms. It also indicated a potential effect of impaired laryngeal sensitivity, which was associated with decreased odds of improvement with CL. With CL, significantly fewer unsafe swallows were observed in PwPD. Incorporating CL in instrumental assessment protocols allows individualized assessment of its effects. Future research should look at mechanisms underlying the impact of CL in this patient group and explore the value of CL in addition to dysphagia rehabilitation strategies.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944495","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":"Method for Classifying Spectrograms of Acoustic Signals from Swallowing of Individuals with and without Dysphagia Using a Convolutional Neural Network.","authors":"Gabriele Pessoa da Silva, Rafaela Soares Rech, Tiago Becker, Carla Diniz Lopes Becker","doi":"10.1007/s00455-026-10983-y","DOIUrl":"https://doi.org/10.1007/s00455-026-10983-y","url":null,"abstract":"<p><p>Dysphagia is highly prevalent and may lead to important clinical complications. Although traditional diagnostic methods are effective, they have limitations, including high cost and patient discomfort. Cervical auscultation is a non-invasive technique for monitoring swallowing sounds and may support dysphagia assessment. To present a method for analyzing and classifying acoustic signals obtained through cervical auscultation of individuals with and without dysphagia using a machine learning approach. Cross-sectional study including swallowing assessments from individuals aged 18 years or older. Simultaneously with the clinical assessment of dysphagia, swallowing sounds were recorded using an Eko Core amplifier coupled to a 3 M-LITTMANN stethoscope. The stethoscope was positioned over the lateral edge of the trachea just below the participant's cricoid cartilage, and the participant was instructed not to speak or make unnecessary sounds during the recording to minimize background noise. Acoustic signals from individuals with and without dysphagia were captured with a digital stethoscope and stored for analysis. A total of 178 swallowing signals were selected, segmented, and augmented to 1,888 isolated events, which were converted into spectrograms using the Short-Time Fourier Transform. The learning model used was a convolutional neural network associated with a cross-validation system. The model achieved an accuracy of 77.7% and a sensitivity of 76.6%, but relatively low precision (64.1%). The area under the ROC curve was 0.823. This study advances the automation of dysphagia assessment by showing that acoustic analysis supported by neural networks may complement traditional methods. Future investigations should focus on improving model robustness and clinical applicability to support a more accessible and less invasive diagnostic approach.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929082","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":"The Relationship between Swallowing Muscle Mass and Tongue Muscle Strength and Endurance in Head and Neck Cancer Patients.","authors":"Javier Hurtado-Oliva, Lucy Núñez-Miranda, Guus van der Valk, Jeroen Vister, Anouk van der Hoorn, Inge Wegner, Gyorgy B Halmos","doi":"10.1007/s00455-026-11001-x","DOIUrl":"https://doi.org/10.1007/s00455-026-11001-x","url":null,"abstract":"<p><p>Sarcopenic dysphagia is a significant concern in head and neck cancer (HNC) patients and contributes to malnutrition, aspiration pneumonia and poor clinical outcomes. Although tongue strength (TS) and swallowing muscle mass (SwMM) are central components of swallowing physiology, their relationship in HNC patients remains unclear. This study investigated the association between SwMM and TS and tongue endurance in HNC patients. This prospective cross-sectional study was conducted at the University Medical Center Groningen between February 2023 and April 2025. Fifty-three patients with primary mucosal HNC were included before treatment. SwMM was quantified on contrast-enhanced CT scans using the mid-sagittal tongue complex muscle (TCM) area as a proxy for SwMM volume. TS and tongue endurance were measured with the Iowa Oral Performance Instrument. Associations were evaluated using Pearson and Spearman correlation analyses and univariable and multivariable linear regression adjusted for age, sex, and nutritional status. SwMM was not significantly correlated with maximum TS at the anterior or posterior positions (r = 0.080 and r = 0.048, respectively; both p > 0.05), nor with tongue endurance (r= - 0.043 and r= - 0.004, respectively; both p > 0.05). Regression analyses confirmed that SwMM was not significantly associated with tongue performance, including in adjusted multivariable models. SwMM and tongue muscle performance represent distinct physiological domains in untreated HNC patients. The mid-sagittal TCM area, as a proxy for SwMM, was not associated with tongue pressure capacity, suggesting that TS alone may overlook lower SwMM. CT-based SwMM assessment is feasible but should complement functional assessments for a comprehensive evaluation of sarcopenic dysphagia.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879253","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":"Clinical Conundrum: Chest Discomfort on Swallowing in a Patient with Stiff-Person Syndrome.","authors":"Yoya Ono, Kenjiro Kunieda, Megumi Yamada, Takayoshi Shimohata","doi":"10.1007/s00455-026-10996-7","DOIUrl":"https://doi.org/10.1007/s00455-026-10996-7","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857036","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 Suprahyoid Muscle Activation During Inspiratory Muscle Training and the Shaker Exercise: An Exploratory Pilot Study.","authors":"Kazuaki Suyama, Hideki Shibata, Ryunosuke Nishida, Yuta Noda, Motoyoshi Morishita","doi":"10.1007/s00455-026-10999-4","DOIUrl":"https://doi.org/10.1007/s00455-026-10999-4","url":null,"abstract":"<p><p>Inspiratory muscle training (IMT) has been discussed in the context of swallowing rehabilitation, yet its neuromuscular characteristics relative to established swallowing exercises remain unclear. This study aimed to compare profiles of muscle activation amplitude during IMT and the Shaker exercise, with a focus on task-specific recruitment of the suprahyoid, cervical, and respiratory muscles. In a single-center, prospective crossover study, healthy young adults performed IMT using a flow-resistive device and the Shaker exercise in randomized order. Surface electromyography (sEMG) was recorded from the anterior digastric, sternocleidomastoid, trapezius, and diaphragm-related respiratory muscles. sEMG amplitudes were normalized to maximal voluntary contraction (%MVC). Paired comparisons were conducted, with outlier handling, sensitivity analyses, and exploratory equivalence testing for digastric muscle activity. Twenty-four participants were analyzed. Digastric muscle activation differed significantly between tasks, with lower activation during IMT compared with the Shaker exercise. Sternocleidomastoid and trapezius activity also showed task-dependent differences, with higher sternocleidomastoid activation during the Shaker exercise and higher trapezius activation during IMT. Diaphragm-related activity did not differ significantly between conditions. Sensitivity analyses yielded consistent findings across datasets, and equivalence for digastric activation was not demonstrated within predefined margins. IMT and the Shaker exercise impose distinct neuromuscular demands despite partial overlap in the muscles involved. Whereas the Shaker exercise directly loads the suprahyoid muscles as primary movers, IMT engages them indirectly within respiratory and postural coordination. These findings support considering IMT as a complementary, rather than substitutive, approach to established swallowing exercises.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856984","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}