Dysphagia最新文献

{"title":"Pharyngolaryngeal Abnormalities viewed via nasoendoscopy associated with Oropharyngeal Dysphagia in Adults: A Scoping Review.","authors":"Sarah Boggiano, Amy Freeman-Sanderson, Anna Miles, Emma Power, Kris Rogers, Sarah Wallace","doi":"10.1007/s00455-025-10884-6","DOIUrl":"https://doi.org/10.1007/s00455-025-10884-6","url":null,"abstract":"<p><p>To identify in the literature which pharyngolaryngeal abnormalities (PLA) co-occur or are associated with oropharyngeal dysphagia when viewed via nasoendoscopy. Flexible Endoscopic Evaluation of Swallowing (FEES) is an examination used to assess swallowing. Currently there are no standardized frameworks to observe and report on PLAs observed during a FEES procedure to support diagnostics and inform management. Multiple databases (Scopus (Elsevier), Medline (Ovid), CINAHL (EBSCO) and EMBASE (Ovid)) were searched against inclusion criteria from 1980 to 2024. Key search terms included variations of larynx, pharynx, FEES, and oropharyngeal dysphagia. The study utilized PRISMA-ScR reporting items. Two independent reviewers screened in two phases. Reporting of PLAs with oropharyngeal dysphagia was represented using frequency of co-occurrence and, where available, any statistical analyses attempting to demonstrate an association. Prevalence was calculated for PLA and presence of signs/symptoms of oropharyngeal dysphagia. 117 articles were included for full text review. Data were synthesized into 24 PLA within six categories. PLAs with both frequency of co-occurrence and statistical analysis attempting to demonstrate an association with oropharyngeal dysphagia included unilateral vocal fold motion impairment (UVFMI), velopharyngeal insufficiency, arytenoid motion impairment, incomplete glottic closure, vocal fold atrophy/bowing, edema, and hematoma. This scoping review presents evidence relating to PLAs seen via nasoendoscopy and their reported co-occurrence with oropharyngeal dysphagia. Overall, seven PLA were shown to have an association with oropharyngeal dysphagia, and a further 11 PLA had frequency of co-occurrence with oropharyngeal dysphagia without statistical analysis to support association. Whilst these findings suggest a relationship between PLA and oropharyngeal dysphagia, further research is required to confirm causation of each PLA on swallowing function. Systematic swallowing assessment and use of outcome measures that consider the presence of pharyngolaryngeal abnormalities, will help generate rigorous evidence that is needed to advance precision in diagnostics of swallowing impairment and subsequent interventions.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112276","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: Dysphagia and Oral Health in Older Adults with Motoric Cognitive Risk Syndrome.","authors":"Özgü İnal Özün, Senem Demirdel, Necmiye Ün Yıldırım, Mehmet İlkin Naharci","doi":"10.1007/s00455-025-10886-4","DOIUrl":"https://doi.org/10.1007/s00455-025-10886-4","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079952","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":"Validity of Aspiration Prevention Surgery in Elderly Patients with Cerebrovascular or Neurodegenerative Disorders.","authors":"Masahiko Y Kida, Mitsuyoshi Imaizumi, Toshiyuki Yamamoto","doi":"10.1007/s00455-025-10889-1","DOIUrl":"https://doi.org/10.1007/s00455-025-10889-1","url":null,"abstract":"<p><p>The risk of aspiration pneumonia has been reported to increase with age, especially in frail elderly patients with cerebrovascular and/or neurodegenerative disorders. To prevent this type of pneumonia, aspiration prevention surgery (APS) procedures have been demonstrated to be effective. However, the comprehensive efficacy of APS, not only in terms of survival rates, but also in terms of medical costs and caregiver burden, has not been fully evaluated in elderly patients requiring aspiration care. Thus, the aim of the current study was to demonstrate the validity of APS in elderly patients with cerebrovascular or neurodegenerative disorders. A total of 135 patients were enrolled; 82 with cerebrovascular disorders and 53 with neurodegenerative disorders, in whom APS was applied to 52 and 36 patients, respectively. The 2-year survival rates, medical costs, and number of suctioning procedures as a measure of caregiver burden were investigated in patients treated with APS (the APS group) and those without APS (the non-APS group). The 2-year survival rates for all patients were 53.4% in the APS group and 4.3% in the non-APS group. This result showed significantly better outcomes in the APS group. Moreover, in the APS group, the postoperative suction frequency showed a significant decrease compared to the preoperative suction frequency. Finally, medical costs were significantly lower in the APS group compared to the non-APS group. The results of this study demonstrate that APS contributed to improved survival rates, reduced medical costs, and a decrease in suctioning frequency in elderly patients with cerebrovascular or neurodegenerative diseases.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079867","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":"Swallowing Disorders, Survival and Functionality in Adults with Advanced Cancer Outside the Head and Neck and Upper Gastrointestinal Tract in Outpatient Palliative Care Setting: A Prospective Cohort Study.","authors":"Danielle Nunes Moura Silva, Yohane Cristina Guimarães Jardim, Laélia Cristina Caseiro Vicente, Amélia Augusta de Lima Friche","doi":"10.1007/s00455-025-10876-6","DOIUrl":"https://doi.org/10.1007/s00455-025-10876-6","url":null,"abstract":"<p><p>In palliative care, there is still a lack of data regarding the relationship between survival, symptoms, and functionality. To investigate the relationship between functionality and both dysphagia-progression-free survival and overall survival in patients with advanced cancer. A prospective cohort conducted between March 2022 and August 2023. The study was conducted with patients with advanced cancer outside the head and neck and upper gastrointestinal tract, followed by an outpatient palliative care team. Sociodemographic, psychosocial, clinical, functional, and nutritional data were analyzed. A speech therapy evaluation was performed to classify swallowing disorders and the feeding route associated with swallowing ability. Two cohorts were analyzed according to functionality. 39 individuals were eligible, the majority being female. Lower functionality was a significant risk factor for mortality (p < 0.05), with a 4.31-fold increased risk of death. Minimal swallowing declines were associated with worse survival in patients with poorer functionality in univariable analysis (p = 0.01), but this association was not observed in multivariable analysis. Declining functionality was identified as a significant risk factor for mortality. Swallowing ability revealed a negative impact on survival in univariable analysis, however this association was not confirmed in the multivariable model. Likewise, dysphagia-progression-free survival was shorter among patients with poorer functionality, although this was not statistically significant in multivariable analysis. These findings underscore the need for further investigation.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052563","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":"Using Machine Learning for the Automated Segmentation and Detection of Swallows Obtained by Digital Cervical Auscultation in Preterm Neonates.","authors":"Stephen So, Timothy Tadj, Belinda Schwerin, Anne B Chang, Seiji Humphries, Thuy T Frakking","doi":"10.1007/s00455-025-10879-3","DOIUrl":"https://doi.org/10.1007/s00455-025-10879-3","url":null,"abstract":"<p><p>The clinical application of acoustic swallowing sound parameters collected from digital cervical auscultation is limited because of the time-consuming manual segmentation required by trained experts. The automated identification of swallowing sounds in children and adults from swallowing sound audio wavefiles using machine learning have accuracies between 76-95%. No data exists in preterm neonates. To determine if applying automated machine learning using a transfer learning approach could accurately identify and segment swallows from swallowing sounds collected in preterm neonates. Thin fluid swallow sounds were collected from 78 preterm neonates, median birth age 34 weeks gestation (range 25-36 weeks, 52.6% males) across 3 Australian special care nurseries. For the base machine learning model, a deep convolutional neural network (DCNN) pre-trained for audio event classification was used. With raw swallow audio data as input, embedding vectors from the base DCNN were generated and used to train a feedforward neural network to determine the presence of a swallow within an audio segment. The model showed high overall accuracy (94%) in identifying preterm swallows. Better model performance on bottle feeding swallows (Sensitivity, 95%; and specificity, 96%) was seen compared with breastfeeding swallows (sensitivity, 95%, specificity 92%). Interpretation: Our novel study demonstrates the successful use of transfer learning to accurately identify and segment digital swallowing sounds in preterm neonates. Application of this model could support the development of a digital CA app to automatically classify swallow sounds and improve objectivity for CA use in clinical practice within special care nurseries.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039351","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":"Swallowing Guidance with FEES May Alleviate Symptoms in Functional Dysphagia.","authors":"Jonna Kuuskoski, Jami Rekola, Harri Sintonen, Leena-Maija Aaltonen, Pia Järvenpää","doi":"10.1007/s00455-025-10869-5","DOIUrl":"https://doi.org/10.1007/s00455-025-10869-5","url":null,"abstract":"<p><p>Dysphagia is a common concern. In an outpatient phoniatric and otorhinolaryngology clinic, approximately one fourth of dysphagia patients are classified as having non-organic, or functional dysphagia. This study aimed to evaluate symptom severity, health-related quality of life (HRQoL) and disability among dysphagia patients. Additionally, it focused on assessing the impact of flexible endoscopic evaluation of swallowing (FEES) and swallowing guidance particularly for patients with functional dysphagia. We recruited 60 consecutive dysphagia patients from our phoniatrics clinic. They completed the Eating Assessment Tool (EAT-10), the 15D Health-related Quality of Life Instrument and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaires before their appointments. We performed FEES and gave swallowing guidance. One month later, the patients repeated the EAT-10, 15D, and WHODAS 2.0. At one-month follow-up, the EAT-10 scores of all 60 dysphagia patients (median age 65, range 18-89 years, 70% female), and the functional dysphagia patients (n = 15, 25%) had decreased significantly (p = 0.020, p = 0.029, respectively). Although the changes in the 15D and WHODAS 2.0 scores were insignificant, the score of WHODAS 2.0 item D3.3 concerning eating had decreased significantly in the functional dysphagia group (p = 0.020). Comparison of the whole dysphagia patient cohort to an age- and gender-standardized sample of the general population revealed significant differences in 15D total scores (p < 0.001) and 12 of the 15 dimensions. Dysphagia seems to significantly diminish patients' HRQoL in comparison to that of the general population. A short FEES intervention with swallowing guidance may alleviate symptoms, especially in functional dysphagia.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039332","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":"Effect of Localized Muscle Vibration on Oral and Swallowing Pressure in Patients with Dysphagia Following Stroke.","authors":"Jong-Chi Oh, Min-Sook Shin, Mo-A Son, Hyeon-Ji Kim","doi":"10.1007/s00455-025-10883-7","DOIUrl":"https://doi.org/10.1007/s00455-025-10883-7","url":null,"abstract":"<p><p>This study examined the effects of vibratory stimulation on swallowing-related muscle strength in patients with dysphagia due to stroke, using three types of stimulators and a systematic exercise program. This study was conducted in two stages. In Experiment 1, we examined the effects of three types of vibratory stimulation on the pressure of the tongue and lips (N = 23). In Experiment 2, the effect of submental vibratory stimulation applied during the effortful swallowing (ES) exercise program-consisting of five sets-on swallowing pressure, was examined (N = 37). Vibratory stimulation was applied to the corresponding muscles for 1 min immediately prior to measuring isometric peak pressure or swallowing pressure of the tongue and lips. In Experiment 1, the electric toothbrush showed a limited increase in strength in two tongue-related variables, while the mini-massager and customized vibratory stimulator showed significant increases in strength in all five variables related to tongue and lip pressure (p < 0.05). In Experiment 2, it was found that vibration applied to the submental area for 1 min before each set of ES exercises, consisting of 10 repetitions, significantly increased oral swallowing pressure. This study shows the following preliminary results, which are encouraging and require replication: vibratory stimulation applied to swallowing-related muscles can significantly increase their strength in the short term. Further research through larger trials is necessary to confirm efficacy, determine optimal stimulation parameters, and evaluate effects on functional swallowing.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023037","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":"Adaptation of the Italian Version of the Mealtime Assessment Scale in Pediatric Population (MAS-p).","authors":"Laura Antonucci, Paola Carrozza, Maria Pia Taglioli, Francesca Alberti, Silvia Pancani, Sara Della Bella, Claudio Macchi, Giovanna Cristella","doi":"10.1007/s00455-025-10873-9","DOIUrl":"10.1007/s00455-025-10873-9","url":null,"abstract":"<p><p>Unlike what is observed in the adult population, in paediatric rehabilitation, no reliable and validated observational tools are available in the Italian language to evaluate subjects considered to be at risk for swallowing disorders, regardless of the pathology. The aim of this study was to adapt the Mealtime Assessment Scale (MAS) to a paediatric population. Additionally, internal consistency, intra-rater and inter-rater agreement, concurrent validity and discriminative ability were investigated to assess validity and reliability of the scale. The first part of the study consisted in an adaptation of the original version of the MAS to the paediatric population (MAS-p) by a multidisciplinary team. A pilot study, involving 40 subjects, was conducted to assess psychometric properties as validity and reliability in terms of internal consistency, intra- and inter-rater reliability, and discrimination index. Retaining MAS original structure and scoring system, items were maintained, modified, or removed through a revision by the multidisciplinary team to guarantee a correct evaluation in children. None of the patients were lost or had withdrawn. MAS-p showed good internal consistency, both in safety (Cronbach's alpha 0.857) and efficacy scale (Cronbach's alpha 0.885). No improvement was noticed removing items one at a time and an optimal item to total correlation was observed (Cronbach's alpha ≥ 0.80). No items were found to be not assessable. Intra-rater and inter-rater agreement were good for all items (ICC > 0.8 for intra-rater agreement and AD index < 0.66 for inter-rater agreement). A second revision of the scale was carried out by the multidisciplinary team after the pilot study to further modify items to fully adapt to the paediatric population. MAS-p was developed to introduce an objective dysphagia assessment in paediatric rehabilitation. It showed good validity and reliability. The validation process should be completed through further studies.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946956","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":"Alpha-Synuclein Lesions in the Peripheral Nervous System of the Larynx in Parkinson's Disease.","authors":"Liancai Mu, Jingming Chen, Themba Nyirenda, Jing Li, Karen Wheeler Hegland, Charles H Adler, John N Caviness, Holly A Shill, Geidy E Serrano, Thomas G Beach","doi":"10.1007/s00455-025-10870-y","DOIUrl":"https://doi.org/10.1007/s00455-025-10870-y","url":null,"abstract":"<p><p>Swallowing, speech and voice (SSV) disorders are very common in Parkinson's disease (PD). The aim of the present studies was to test our hypothesis that PD pathology affects the peripheral nervous system (PNS) of the larynx, thus possibly contributing to SSV deficits. Twenty-eight adult human larynges obtained from autopsied subjects with clinically diagnosed and neuropathologically confirmed PD (n = 20) and age-matched healthy controls (n = 8) were studied. Three laryngeal nerves (i.e., recurrent laryngeal nerve, RLN; external and internal superior laryngeal nerves, ESLN and ISLN), three muscles (i.e., thyroarytenoid, TA; posterior cricoarytenoid, PCA; and cricothyroid, CT), and three mucosa samples overlying the larynx and laryngopharynx (i.e., true vocal fold, TVF; laryngeal surface of the epiglottis, LSE; and aryepiglottic fold, AEF) were examined to detect phosphorylated α-synuclein (PAS) aggregates, the pathological hallmark of PD. The severity of the PAS lesions in the examined tissues was quantified by using a total PNS pathology score we newly developed. The results showed that the larynx was affected by PAS pathology in PD subjects but in none of the controls. The relative contributions of the PNS and brain pathologies to SSV disorders were analyzed. In this series, SSV severity levels in a substantial percentage (45%) of PD patients were more consistent with PNS than brain pathology severity levels. These findings suggest that in addition to brain pathology, PAS lesions in the PNS of the larynx also play an important role in the development of SSV disorders in PD.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946896","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":"A Challenging Case of Severe Dysphagia in Multiple System Atrophy.","authors":"Miguel Limbert Ramos, Rumi Ueha, Takao Goto, Kentaro Ichijo, Hirofumi Sugita, Yuichiro Shirota, Kenji Kondo","doi":"10.1007/s00455-025-10871-x","DOIUrl":"https://doi.org/10.1007/s00455-025-10871-x","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854883","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}