Dysphagia最新文献

{"title":"Preliminary Validation of Dynamic Imaging Grade of Swallowing Toxicity (DIGEST_V2) for Characterizing Swallow Safety and Efficiency in Post-Stroke Populations.","authors":"Brittany N Krekeler, Anna Hopkins, Claudia Vollman, Kate Davidson, Erin Broderick, Mekibib Altaye, Meredith Tabangin, Bonnie Martin-Harris, Katherine A Hutcheson","doi":"10.1007/s00455-025-10857-9","DOIUrl":"https://doi.org/10.1007/s00455-025-10857-9","url":null,"abstract":"<p><p>The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) rating method was developed in head and neck cancer populations to describe severity of aspiration and residue. The purpose of this study was to assess criterion validity of DIGEST in a post-stroke cohort. In this retrospective analysis, two raters (using version two criteria) performed DIGEST_V2 rating on recordings of modified barium swallow studies (MBSS) from 88 post-stroke patients that were extracted from a larger de-identified database. Modified Barium Swallow Study Impairment Profile (MBSImP) scores and Functional Oral Intake Scale (FOIS) scores were used to determine criterion validity. Inter-rater and intra-rater reliability for overall DIGEST_V2 grade were substantial (ƙ = 0.69 and 0.73, respectively), however inter-rater reliability for efficiency were only moderately reliable (ƙ = 0.52). Reliability for MBSImP scoring was excellent for Pharyngeal Total (PT) scores (ICC = 0.81-0.93). Overall DIGEST_V2 grades were significantly associated with PT scores in the expected direction (τ = 0.51, p < 0.0001), and there was no association between Oral Total (OT) and DIGEST grade (τ = -0.01, p = 0.889). Pairwise comparisons using PT scores indicated significant differentiation between DIGEST_V2 grades 0 from all other grades (p < 0.0001), with overlap in intermediate grades (p = 0.102-0.711). Functional Oral Intake Scale (FOIS) scores were significantly associated with DIGEST_V2 grade in the anticipated direction (τ = -0.43, p < 0.0001). Expected psychometrics and acceptable reliability for DIGEST_V2 grading were shown in this post-stroke cohort. A larger dataset would clarify mid-grade differentiation and potential influence of oral phase impairments in this sub-population.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854884","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":"Efficacy of Action Observation Therapy on Patients with Dysphagia After Stroke: A Randomized Controlled Trial.","authors":"Hongyi Zheng, Liyuan Yu, Shuang Chen, Hong Luo, Wei Cui, Li Xu","doi":"10.1007/s00455-025-10866-8","DOIUrl":"https://doi.org/10.1007/s00455-025-10866-8","url":null,"abstract":"<p><p>To investigate the efficacy of Action Observation Therapy (AOT) which is conducted by observing and imitating swallowing videos for post-stroke dysphagia. 36 patients with post-stroke dysphagia were randomly assigned to an observation group or a control group equally. Both groups received routine dysphagia rehabilitation. AOT, was conducted for observation group while control group watched a same-duration landscape video before lunch and dinner．Before and after treatment, Watian Swallowing Test (WST), Eating Assessment Tool (EAT-10), Standard Swallowing Assessment (SSA), Functional Oral Intake Scale (FOIS), surface electromyogram (sEMG) and functional near-infrared spectroscopy (fNIRS) were conducted. After 3 weeks of treatment, WST, EAT-10, SSA, and duration of swallowing muscle groups of both groups significantly decreased (P ＜ 0.05). FOIS and amplitude of swallowing muscle groups of both groups significantly increased (P ＜ 0.05). Except for duration of subhyoid muscles and FOIS, other parameters in observation group were significantly improved compared to those in control group ( P ＜ 0.05). fNIRS showed that overall brain function connection was not significantly enhanced, but significant differences in bilateral primary motor cortex/supplementary motor cortex (PMC/SMC), left dorsolateral prefrontal cortex (DLPFC) and right Broca area were observed. Correlation analysis revealed that changes in amplitude of suprahyoid group muscle had a negative correlation with EAT-10 and SSA scores ( r = -0.332, -0.421, P ＜0.05). AOT based on observation and imitation of swallowing videos can enhance the strength of swallowing related muscles (such as the suprahyoid muscle group), shorten swallowing time, optimize the swallowing process, and ultimately promote the recovery of post-stroke swallowing function. Its mechanism may be related to the activation of brain regions such as PMC/SMC, DLPFC, and Broca area.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816064","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 Predictors of Dysphagia in Acute and Subacute Traumatic Cervical Spinal Cord Injury: A Retrospective Observational Study.","authors":"Yong Beom Shin, Jin A Yoon, Byeong Ju Lee, Myung Hun Jang, Hyuk Jin Choi, Sang Hun Kim","doi":"10.1007/s00455-025-10865-9","DOIUrl":"https://doi.org/10.1007/s00455-025-10865-9","url":null,"abstract":"<p><p>Using the first videofluoroscopic swallowing study (VFSS), we aimed to identify clinical predictors of dysphagia in patients with acute and subacute traumatic cervical spinal cord injury (TCSCI). This retrospective chart review included 143 adults, who were diagnosed with TCSCI and underwent their first VFSS between 2018 and 2021. Patients with alert mental status and no history of traumatic brain injury or preexisting conditions causing dysphagia were included. The neurological status was assessed using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Dysphagia was evaluated using the penetration-aspiration scale and the pharyngeal residue severity rating scale. Cervical alignment was assessed by measuring the O-C2 and C2-C6 angles and the narrowest oropharyngeal diameter. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of dysphagia. Tracheostomy and age ≥ 65 years were identified as significant predictors of dysphagia. Tracheostomy was strongly associated with a higher risk of penetration-aspiration (odds ratio [OR] = 8.33, P = 0.001), whereas age ≥ 65 years was a significant predictor of pharyngeal residue (OR = 4.45, P < 0.001). Despite showing a trend toward significance in univariate analysis, increased cervical lordosis (C2-C6 angle) was not confirmed as an independent predictor in multivariate analysis. Tracheostomy and advanced age are significant early predictors of dysphagia in acute and subacute TCSCI. Early bedside screening, followed by timely instrumental assessment such as VFSS, is essential to detect dysphagia before initiating oral intake and to implement preventive strategies that may reduce aspiration-related complications.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816063","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":"Abnormal Swallowing Characteristics in COVID-19 Patients.","authors":"Pajeemas Kittipanya-Ngam, Marlís González-Fernández","doi":"10.1007/s00455-025-10836-0","DOIUrl":"https://doi.org/10.1007/s00455-025-10836-0","url":null,"abstract":"<p><p>This study aimed to characterize the abnormal swallowing features observed during Videofluoroscopic Swallowing Studies (VFSS) in moderate to severe COVID-19 patients. From the JH CROWN cohort database (January 2020 to March 2022), a total of 3,660 patients with moderate to severe COVID - 19 disease requiring oxygen supplementation were identified. The study abstracted and reported VFSS referral rates and swallowing characteristics using Modified Barium Swallow Impairment Profile (MBSImP). 16% (n = 588) of patients exhibited dysphagia; only half underwent VFSS. Among those referred, 39.3% had COVID-19 severity level 7, 39% exhibited aspiration, and 30% had silent aspiration. Abnormal MBSImP scores were reported in the following components: tongue control during bolus hold (score 2/3, 40%), bolus transport and lingual motion (score 3/4, 34%), oral residue (score 2/4, 57.7%), initiation of pharyngeal swallow (score 3/4, 65.2%), laryngeal vestibular closure (score 1/2, 64.5%), and pharyngeal residue (score 2/4, 50.5%). In conclusion, this large cohort of COVID-19 patients exhibited a myriad of swallowing abnormalities in the oral and pharyngeal phases, with a notably high rate of silent aspiration. Moreover, differentiating COVID-19-induced dysphagia from post-extubation dysphagia is challenging.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803771","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":"Dysphagia Following Anterior Cervical Discectomy and Fusion: A PearlDiver Analysis of Incidence, Risk Factors, and Interventions.","authors":"James Cochran, Nancy Deng, Ameer Tabbaa, Afshin Razi, Sara Abu-Ghanem","doi":"10.1007/s00455-025-10867-7","DOIUrl":"https://doi.org/10.1007/s00455-025-10867-7","url":null,"abstract":"<p><p>Anterior cervical discectomy and fusion (ACDF) is a well-established surgical procedure, with wide variation in reported postoperative dysphagia rates (1-79%). No standardized guidelines exist for screening, diagnosis, and treatment of postoperative ACDF dysphagia. The goal of the current study is to utilize a large database of US healthcare insurance claims to investigate incidence of dysphagia post-ACDF as well as risk factors for dysphagia and interventions performed in a large patient cohort. PearlDiver database was used to identify patients without preoperative dysphagia undergoing ACDF between 2010 and 2022 and create cohorts of patients with and without postoperative ACDF dysphagia. International Classification of Disease version 9 and 10 (ICD-9 and ICD-10), and Current Procedural Terminology (CPT) codes were used to retrieve patient records. The two cohorts were compared in terms of age, gender, comorbidities, prior neck surgery, postoperative vocal fold paralysis, and dysphagia related interventions. OR with 95% CI were calculated, stratifying by various risk factors. Prevalence of various postoperative diagnoses and interventions were calculated. Of 618,170 patients undergoing primary ACDF from 2010 to 2022, 88,899 (14.4%) developed postoperative dysphagia. Females, smokers, diabetics, and obese patients had higher odds of developing post ACDF dysphagia (OR 1.14, 2.51, 2.18, 2.50 respectively). 3% of patients with post ACDF dysphagia had new postoperative vocal fold motion impairment (VFMI) versus 0.3% without dysphagia (OR 8.69). Within the dysphagia cohort,14.9% underwent laryngoscopy, 19.0% underwent MBSS, 0.80% underwent FEES, and 5.2% received swallow therapy. Dysphagia is commonly diagnosed after ACDF, with females, smokers, diabetics, and obese patients having the highest odds of diagnosis. Yet, a low percentage of patients are being referred for evaluation or treatment. Providers performing ACDF should consider screening protocols and early referral to providers offering interventions for dysphagia diagnosis and treatment.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798505","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 Effectiveness of Botulinum Toxin Injection for Cricopharyngeal Dysfunction-Related Dysphagia in Nasopharyngeal Carcinoma Patients.","authors":"Kai-Hsiang Hu, I-Pei Lee, Shu-Wei Tsai, David Shang-Yu Hung, Miyuki Hsing-Chun Hsieh, Yi-Jen Chen, Jenn-Ren Hsiao, Cheng-Chih Huang, Chun-Yen Ou, Chan-Chi Chang, Wei-Ting Lee, Sen-Tien Tsai, Hui-Chen Su","doi":"10.1007/s00455-025-10868-6","DOIUrl":"https://doi.org/10.1007/s00455-025-10868-6","url":null,"abstract":"<p><p>To evaluate the effectiveness of botulinum toxin injection in improving swallowing function in patients with cricopharyngeal muscle dysfunction (CPMD) following radiotherapy for nasopharyngeal carcinoma (NPC). Cohort study. Outpatients with NPC-related CPMD receiving endoscopy-guided botulinum toxin injection at National Cheng Kung University Hospital between 2017-2024. 15 NPC patients with CPMD were enrolled. Swallowing function was assessed using the functional oral intake scale (FOIS), penetration-aspiration scale (PAS), bolus residue scale (BRS), dynamic imaging grade of swallowing toxicity (DIGEST), normalized residue ratio scale for vallecular (NRRS_V) and pyriform sinus (NRRS_P), laryngeal elevation, epiglottic retroflexion, pharyngeal contraction ratio(PCR), bolus clearance ratio (BCR), and temporal swallowing parameters (oral transit time [OTT], pharyngeal response time [PRT], pharyngeal delay time [PDT], pharyngeal transit time [PTT], laryngeal elevation delay time [LEDT]). The Wilcoxon signed-rank test was used to compare pre- and post-injection data. FOIS significantly improved after botulinum toxin injection (p = 0.0002). Objective measures showed a significant reduction in NRRS_P (p = 0.0067). Temporal characteristics also demonstrated significant improvement in OTT, PRT, and PTT (p = 0.0156, p = 0.0303, p = 0.0284, respectively). However, other objective measures showed no significant changes. Botulinum toxin injection may benefit specific swallowing parameters, such as NRRS_P, OTT, PTT, and PRT, and enhance FOIS in NPC patients with radiation-induced CPMD. However, its overall impact on swallowing function remains uncertain.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793790","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 Comparison of Oropharyngeal Dysphagia in Alzheimer's Disease versus Older Adults with Presbyphagia.","authors":"Müberra Tanrıverdi, Emre Osmanoğlu, Özlem Gelişin, Ömer Faruk Çalım, Pinar Soysal","doi":"10.1007/s00455-024-10777-0","DOIUrl":"10.1007/s00455-024-10777-0","url":null,"abstract":"<p><p>Dysphagia is defined as difficulty in swallowing, while presbyphagia is described as a change in swallowing process in healthy older adults, which is a compensable physiological impairment and synonymous with dysphagia. Aging is a well-known risk factor for Alzheimer's disease (AD), and oropharyngeal dysphagia (OD) is a common condition in AD. Our study aims to compare OD in AD patients and older adults with presbyphagia (OAwP). 65 older adults (AD = 32, mean age:76.5 ± 6; OAwP = 33, mean age:71.1 ± 4) were included. Swallowing disorders were evaluated by Flexible Endoscopic Evaluation Study, which scored by Penetration Aspiration Scale (PAS) that scores other than 1 indicate dysphagia, Murray Secretion Severity Scale (MSSS), and Eating Assessment Tool-10 (EAT-10). Neurologist determined Clinical Dementia Rating (CDR) scores of AD patients. AD and OAwP groups had OD, respectively, 96.87% vs. 81.81% by PAS, 87.5% vs. 60.60% by MSSS, and 56.25% vs. 18.18% by EAT-10. No statistical differences were observed between AD and OAwP in terms of gender, age, PAS, and MSSS values (p > 0.05). There was a significant difference in EAT-10 total scores (p = 0.000), and had OD by EAT-10 (p = 0.024). No differences were found in age, time elapsed since diagnosis, PAS, and EAT-10 scores based on CDR, but there was a difference in MSSS scores (p = 0.013). CDR in AD were associated with gender, time elapsed since diagnosis, and MSSS scores (p < 0.05). OAwP experience swallowing problems at least as much as those with AD. Evaluation of swallowing disorders after diagnosis is essential for both AD and OAwP. Early-stage management of disease with preventive treatment approaches can delay onset of symptoms.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"792-800"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544404","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":"Diagnostic Validity of Clinical Observations for Detecting Physiologic Swallowing Impairment.","authors":"Munirah Alkhuwaiter, Julia Lee, Bonnie Martin-Harris","doi":"10.1007/s00455-024-10775-2","DOIUrl":"10.1007/s00455-024-10775-2","url":null,"abstract":"<p><p>A clinical swallow evaluation (CSE) is a noninvasive and indirect assessment of the anatomical and physiological integrity of the swallowing mechanism in a natural setting. A CSE goes beyond a screening, a dichotomized indicator of dysphagia risk, by comprehensively examining the patient's swallowing through gaining sensory and motor information of oral and pharyngeal function. Information obtained from CSEs in combination with medical, social, and environmental patient related factors allow clinicians to make critical decisions about patients' health and quality of life. It is essential that we have assessment tools with rigorous methodological quality to optimize the accuracy of our clinical judgement. The purpose of this study is to investigate the diagnostic validity of clinical observations obtained through the Mann Assessment of Swallowing Ability (MASA) to better inform clinicians regarding the confidence that the items are testing what they are intended to test and reflect indication of true physiologic swallowing impairment and airway invasion. Area Under the ROC Curve (AUC) analyses revealed that the MASA's diagnostic validity showed acceptable accuracy levels for detecting oral impairment and aspiration, and poor accuracy for detecting pharyngeal impairment and penetration. In the cross-validation analysis, the AUC accuracy level for aspiration changed from acceptable to poor, but remained the same for oral impairment, pharyngeal impairment and penetration. In our sample, acceptable levels for detecting aspiration but poor levels for detecting pharyngeal impairment indicate that the MASA does an adequate job of identifying risk but not explaining the nature of impairment. These results support the need for videofluoroscopic imaging to identify the nature and severity of swallowing impairment, guide intervention and provide recommendations for safe and efficient oral intake.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"775-785"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616743","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":"Prevalence and Management of Oral Intake Restrictions in Critically Ill Patients: Insights from a Multicenter Point Prevalence Study.","authors":"Takashi Hongo, Tetsuya Yumoto, Keibun Liu, Kensuke Nakamura, Akira Kawauchi, Takefumi Tsunemitsu, Nobuto Nakanishi, Atsunori Nakao, Hiromichi Naito","doi":"10.1007/s00455-024-10772-5","DOIUrl":"10.1007/s00455-024-10772-5","url":null,"abstract":"<p><p>Oral intake restrictions due to dysphagia in the intensive care unit (ICU) can increase morbidity, mortality, and negatively impact quality of life. The current oral intake practice and clinical management strategies for addressing dysphagia in the ICU are not well-defined. This study aimed to elucidate the clinical practices surrounding oral intake restrictions due to dysphagia and its management strategies in the ICU. A multicenter, prospective, cross-sectional, 2-day point prevalence study was conducted in Japan. Relevant data on the clinical circumstances surrounding oral intake practice and the implementation of strategies to prevent dysphagia for patients admitted to the ICU on November 1, 2023, and December 1, 2023, were collected. The primary outcome was the prevalence of oral intake restrictions in patients, defined by a Functional Oral Intake Scale score of less than 7 among eligible patients for oral intake. Out of 326 participants, 187 were eligible for the final analysis after excluding 139 patients who were not eligible for oral intake, primarily due to tracheal intubation. Among those eligible, 69.0% (129/187) encountered oral intake restrictions. About 52.4% (98/187) of patients underwent swallowing screenings; 36.7% (36/98) of these were suspected of having dysphagia. Compensatory and behavioral swallowing rehabilitation were provided to 21.9% (41/187) and 10.6% (20/187) of patients, respectively, from ICU admission to the survey date. Only 27.4% (14/51) of post-extubation and 9.3% (3/32) of post-stroke patients received swallowing rehabilitation. Notably, no ICUs had dedicated speech and language therapists, and most (85.7%, 18/21) lacked established swallowing rehabilitation protocols. This 2-point prevalence survey study revealed that oral intake restrictions due to dysphagia are common in ICUs, but few patients are screened for swallowing issues or receive rehabilitation. More clinical studies are needed to develop effective protocols for identifying and managing dysphagia, including screenings and rehabilitation in the ICU.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"747-758"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460676","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}

{"title":"Time to Onset of Dysphagia Following Head and Neck Radiation.","authors":"E Marin Miller, Rameen K Walters, Shaun A Nguyen, Jennifer L Harper, Bradley Depaoli, Ashli K O'Rourke","doi":"10.1007/s00455-024-10782-3","DOIUrl":"10.1007/s00455-024-10782-3","url":null,"abstract":"<p><p>To evaluate the time of onset of dysphagia in a cohort of head and neck cancer patients treated with radiation or chemoradiation. Retrospective chart review of adult patients. 237 patients met inclusion criteria for the study. The average age at cancer diagnosis was 62 years (± 12.6) in a predominantly male cohort (n = 198, 83.5%). The most common subsite was oropharyngeal (n = 146, 60.8%) and squamous cell carcinoma in origin (n = 232, 97.9%). Of head and neck cancer patients diagnosed with new onset dysphagia or a dysphagia related diagnosis, nine (3.8%) were diagnosed at six months to 1 year, 12 (5.1%) at 1-2 years, and 17 (7.1%) at greater than 2 years. The mean radiation dose to the larynx was 43.8 Gy (Gy) (± 14.5) and statistically significant across time the periods (p = 0.018, η2 = 0.161). No difference was found between age, HPV status, T stage, smoking history, or tumor site. The majority of head and neck cancer patients treated with chemoradiation who developed dysphagia did so within the acute time period (during treatment and up to 6 months post treatment). However, a substantial proportion of patients also developed dysphagia in later time periods (16%). The incidence of dysphagia in certain time periods may be impacted by laryngeal radiation dose. Therefore, we recommend long term monitoring/screening of these patients so early intervention can occur.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"841-850"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616760","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}