Dysphagia最新文献

{"title":"Ankyloglossia in Infants.","authors":"Azliana Aziz","doi":"10.1007/s00455-026-10933-8","DOIUrl":"10.1007/s00455-026-10933-8","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"890"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389465","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":"Assessment Tools for Intensive Care Unit-Acquired Dysphagia: A Network Meta-Analysis of Diagnostic Accuracy Studies.","authors":"Lijun Ge, Yi Hu, Beiyao Gao, Siyuan Wang, Yan Hou, Haoran Yang, Peijian Wang, Shan Jiang","doi":"10.1007/s00455-026-10928-5","DOIUrl":"10.1007/s00455-026-10928-5","url":null,"abstract":"<p><p>This study aims to determine the diagnostic accuracy for assessment tools as compared to reference standard in Intensive Care Unit-Acquired Dysphagia (ICUAD) using network meta-analysis. Comprehensive searches of PubMed, Embase, and Web of Science were conducted from database inception before May 2025 to identify studies on ICUAD assessment tools. Two reviewers independently performed study screening, data extraction, and quality assessment. All analyses were implemented in R version 4.3.2. True positives (TP), False positives (FP), True negatives (TN), False negatives (FN), Sensitivity, Specificity, Positive predictive value (PPV), and Negative predictive value (NPV) were calculated and used to rank the index tests. Nineteen studies involving 1,167 patients and 11 tools were analyzed. The gold standards, Video Fluoroscopic Swallow Study (VFSS) and Flexible Endoscopic Examination of Swallowing (FEES), showed the highest accuracy. Among bedside tools, the Gugging Swallowing Screen (GUSS) (32.55%) and Standardized Swallowing Assessment (SSA) (42.26%) achieved the best balance of sensitivity and specificity, followed by the modified Volume-Viscosity Swallow Test (mV-VST) (30.07%). GUSS and SSA are practical and reliable bedside tools for ICUAD screening, but cannot replace VFSS or FEES. Further large-scale high-quality prospective studies are needed to confirm their diagnostic performance.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"697-707"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715887","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":"Development and Validation of a Clinical Risk Score for Post-extubation Dysphagia (CRISPED) in Critically Ill Children.","authors":"Paulo Sérgio Lucas da Silva, Emerson Yukio Kubo, Marcelo Cunio Machado Fonseca","doi":"10.1007/s00455-026-10930-x","DOIUrl":"10.1007/s00455-026-10930-x","url":null,"abstract":"<p><p>The purpose of this study was to develop and validate a clinical risk score (CRISPED) for predicting post-extubation dysphagia (PED) in critically ill children. We conducted a prospective cohort study in a pediatric intensive care unit of a tertiary hospital (2021-2025). Consecutive children aged 1 month to 15 years requiring invasive mechanical ventilation ≥ 24 h were eligible. PED was defined as Functional Oral Intake Scale < 6 at first post-extubation speech-language pathology (SLP) assessment. The candidate predictors were evaluated using LASSO logistic regression. The cohort was split into development (n = 300) and validation (n = 132) samples for model assessment. Overall, the PED incidence was 65% among 432 patients included in the study. Three independent predictors were retained: iatrogenic withdrawal syndrome, number of intubations, and intubation duration. The CRISPED score demonstrated strong discrimination in the development cohort (C-statistic 0.85, 95% CI 0.80-0.89; accuracy 75%; Brier score 0.14) with good calibration (Hosmer-Lemeshow p = 0.44). Bootstrap internal validation confirmed minimal optimism with corrected C-statistic 0.84. Performance remained robust in the validation cohort (C-statistic 0.86, 95% CI 0.79-0.92; accuracy 80%; Brier score 0.15). Risk stratification into low (≤ 13 points), intermediate (14-17), and high (≥ 18) categories showed progressive PED prevalence: 21.8%, 61.5%, and 87.5% (p < 0.001). For severe PED (tube dependent patients), discrimination remained good (C-statistic 0.80; accuracy 75.8%). The CRISPED score provides accurate risk stratification for PED using three readily available clinical variables. It enables early identification of high-risk patients for prioritized SLP interventions, potentially improving clinical outcomes. External multicenter validation is essential before widespread clinical implementation.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"788-798"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104142","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":"Risk Factors for Esophageal Stricturing Status Post Total Laryngectomy: A Systematic Review and Meta-analysis.","authors":"Jordan Stellern, Michaele Francesco Corbisiero, Gregory Burnet, Andy Ai, Yifei Ma, Joseph Gaballa, Maxwell Y Lee, Christi Piper, Francesco Bussu, Paul Menard-Katcher","doi":"10.1007/s00455-026-10938-3","DOIUrl":"10.1007/s00455-026-10938-3","url":null,"abstract":"<p><p>Esophageal strictures are a common and morbid complication following total laryngectomy, associated with high recurrence rates and reduced quality of life. This systematic review and meta-analysis aimed to identify risk factors for stricture formation to inform preventative strategies and guide multidisciplinary decision-making. A systematic review was conducted following PRISMA guidelines. Searches of Embase, MEDLINE, and Web of Science identified studies of head and neck cancer patients undergoing total laryngectomy who developed esophageal strictures. The screening and data extraction processes were performed by two independent reviewers. A one-sample meta-analysis for binary outcomes was conducted using a random-effects model with restricted maximum likelihood estimation. The Freeman-Tukey double-arcsine transformation was applied to stabilize variance, and pooled proportions with 95% confidence and prediction intervals were calculated. A meta-regression was used to evaluate study-level covariates. Forty-eight studies (4,919 total laryngectomies, 996 strictures) yielded an overall stricture rate of 20.25%. Prior radiation or chemoradiation was associated with higher stricture rates compared to no radiation (23% vs. 15%, p = 0.029). Laryngopharyngectomy was linked to increased stricture frequency relative to laryngectomy alone (26% vs. 18%, p = 0.017). Hypopharyngeal tumors, advanced nodal disease (N2/N3), and mechanical closure were each associated with higher stricture prevalence (p < 0.01). Tobacco/nicotine use was modestly associated with increased stricture rates (19% vs. 12%, p = 0.042). This analysis identified several clinicopathologic and technical factors associated with post-laryngectomy esophageal strictures. Substantial between-study heterogeneity was observed across analyses, with meta-regression variably explaining this heterogeneity and sensitivity analyses suggesting that a small number of influential studies contributed to variability. While the data from this analysis do not imply causation, consistent associations were observed across multiple studies. Recognition of these patterns may help guide risk counseling, surgical technique selection, and postoperative surveillance, but prospective studies are needed to clarify underlying mechanisms and assess potential interventions.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"855-881"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354142","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":"Influence of Bubble-Containing Thickened Liquid on Swallowing Dynamics.","authors":"Akira Tada, Hiroshige Taniguchi, Makoto Hirumuta, Rikako Sato, Masanori Kimura, Saki Mizutani, Kota Amano, Mana Oshio, Yasunori Muramatsu","doi":"10.1007/s00455-026-10925-8","DOIUrl":"10.1007/s00455-026-10925-8","url":null,"abstract":"<p><p>Thickened liquid (TL) is commonly used to aid swallowing and prevent aspiration in dysphagia patients. We hypothesized that incorporating air bubbles into TL (TLB) could reduce viscosity and pharyngeal residue, improving swallowing dynamics. This study included 24 adults (17 males, 7 females; mean age: 75.8 ± 11.4 years) with Dysphagia Severity Scale scores of 3 or 4, excluding those with laryngeal penetration or aspiration when swallowing 4 mL of TL. Test samples consisted of TL with 3% wt/vol thickening agent and TLB. Type E viscosity and texture profile analysis were conducted. The subjects were administered 4 ml of thickened liquid and 4 ml of thickened liquid with bubbles three times each in a random order. Swallowing dynamics were evaluated using videofluoroscopy, measuring hyoid displacement, velocity, duration, pharyngeal transit time, upper esophageal sphincter (UES) opening width, and pharyngeal residue ratios. No significant differences were observed in adhesion or cohesion between TL and TLB, while viscosity and specific gravity tended to be lower for TLB. Compared to TL, TLB significantly increased hyoid anterior displacement and velocity (p = 0.03, p < 0.01, respectively), shortened movement duration (p < 0.01), and widened UES opening (p < 0.01). Additionally, pyriform sinus residue ratio significantly decreased (p = 0.02). These findings suggest that TLB positively influences swallowing dynamics and reduces pharyngeal residue.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"735-744"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092416","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: The Post-tonsillectomy Patient Who Refused to Swallow.","authors":"Chyau Hong Wong, Yi Yuan Ho, Ghin Ern Annie Chieng, Chian Ling Tang, Norsyamira Aida Mohamad Umbaik","doi":"10.1007/s00455-025-10894-4","DOIUrl":"10.1007/s00455-025-10894-4","url":null,"abstract":"<p><p>Tonsillectomy is a common surgical procedure performed by otolaryngologists, primarily indicated for the management of recurrent tonsillitis and obstructive sleep apnea. While postoperative pain and hemorrhage are well-recognized complications, persistent dysphagia following tonsillectomy is rare. In such cases, a comprehensive evaluation is warranted to identify potential mechanical or functional causes. Psychogenic dysphagia is a diagnosis of exclusion and may significantly affect a patient's quality of life. Timely intervention, including detailed swallowing assessment and multidisciplinary team involvement, is essential for optimal recovery. This report presents a case of a 42-year-old male who underwent elective tonsillectomy complicated with secondary postoperative hemorrhage, followed by the development of severe dysphagia attributed to a psychogenic etiology.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"882-885"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437499","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":"Impacts of a Group-Based Intervention To Mitigate Concurrent Chemotherapy and Radiotherapy-Induced Dysphagia: A Retrospective Cohort Study.","authors":"Cindy Levesque-Boissonneault, Nancy Latulippe, Édith Filion, Houda Bahig, Apostolos Christopoulos, Marie-Ève Pelland, Phuc Felix Nguyen-Tân, Charles Martin, Jeff Crukley, Johannes Frasnelli, Marie-Ève Caty","doi":"10.1007/s00455-026-10927-6","DOIUrl":"10.1007/s00455-026-10927-6","url":null,"abstract":"<p><p>Oropharyngeal dysphagia is a prevalent and clinically significant toxicity in patients with head and neck cancer undergoing concurrent chemotherapy and radiotherapy (CCRT). Preventive swallowing interventions, including exercise-based programs initiated during CCRT, are increasingly adopted in clinical practice to minimize CCRT-induced dysphagia. However, maintaining consistent therapeutic adherence remains a major clinical challenge, potentially limiting the effectiveness of these interventions. This study aimed to examine the impacts of a group-based prophylactic swallowing intervention in patients with head and neck cancer (HNC) treated with concurrent chemotherapy and radiotherapy (CCRT). We conducted a retrospective cohort study examining (a) swallowing-related outcomes, (b) therapy attendance and (c) health-related quality of life (HRQOL) outcomes in patients who participated in either (1) an individual prophylactic swallowing intervention (I-PSI), or (2) a group-based prophylactic swallowing intervention (GB-PSI) using Bayesian regression models. Data from 188 medical charts (I-PSI: n = 101; GB-PSI = 87) were included for analysis. Patients in the GB-PSI cohort had a significantly lower probability of reactive nasogastric tube placement compared to the I-PSI cohort (-0.14 [-0.27, -0.06]). They presented with significantly lower dysphagia toxicity grades during CCRT (-0.48 [-0.32, -0.71]) and at treatment completion (-0.44 [-0.27, -0.63]), along with a lower probability of experiencing grade dysphagia at the end of CCRT (-0.2 [-0.07, -0.32]). The GB-PSI cohort attended more therapy sessions during CCRT (1.76 [1.18, 2.1]) but needed fewer swallowing therapy sessions following treatment completion (-0.52 [-0.92, -0.09]). The small sample size for HRQOL did not allow for statistical analysis. Results suggest that a group-based prophylactic swallowing intervention may be a valuable option for patients undergoing CCRT for HNC. Prospective studies are needed to further explore its impact on therapeutic adherence and a broader range of swallowing-related outcomes.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"759-771"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104262","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 Characteristics of Pill Dysphagia in Adults with Swallowing Disorders: A FEES Based Retrospective Study.","authors":"Yael Shapira-Galitz, Alaa Awisat, Nadine Hendi, Raviv Allon","doi":"10.1007/s00455-026-10936-5","DOIUrl":"10.1007/s00455-026-10936-5","url":null,"abstract":"","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"834-843"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644291","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":"Flow Characteristics of Barium Thickened Liquids during Swallowing in Healthy Adults.","authors":"Pimchanok Tuakta, Akapong Kongjaroen, Pawadee Methacanon, Chaiwut Gamonpilas, Nilnetre Mahathanaruk, Sith Phongkitkarun, Paitoon Benjapornlert","doi":"10.1007/s00455-026-10937-4","DOIUrl":"10.1007/s00455-026-10937-4","url":null,"abstract":"<p><p>Modification of liquid viscosity complying with the International Dysphagia Diet Standardisation Initiative (IDDSI) framework is crucial in managing swallowing difficulties in individuals with dysphagia. Despite having similar viscosities, different thickening agents may exhibit varied extensional properties, potentially influencing bolus formation and the movement of oropharyngeal and hyolaryngeal structures during swallowing. This study aims to evaluate the effects of various thickening agents on swallowing behaviour and the extensional properties of boluses across IDDSI levels 1 to 4, using the Videofluoroscopic Swallowing Study (VFSS). Thirty healthy participants consumed 10 mL of liquids thickened with five different thickening agents, prepared at each IDDSI level 1 to 4, during VFSS. The bolus head during swallowing onset, the movement of oropharyngeal and laryngeal structures and the bolus aspect ratio (BAR) were analysed across different thickening agents. With increasing IDDSI levels, the bolus was observed at progressively higher anatomical levels-residing in the valleculae or hypopharynx at IDDSI level 1, and in the oral cavity at IDDSI level 3 and IDDSI level 4. Laryngeal closure duration (LCD) significantly decreased with increasing IDDSI levels (from 1 to 3 and 4). In addition, ThickenUp^® Clear (TUC) yielded the highest LCD among all thickening agents. The BAR remained stable across IDDSI levels and thickening agents, with no significant differences noted. In healthy adults, thicker consistencies positioned the bolus higher in the oropharynx and prolonged laryngeal closure, supporting safer swallowing. Gum-based thickeners produced more cohesive and stable boluses than starch-based agents, allowing more controlled bolus flow and airway protection.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"844-854"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257745","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":"Tongue Strength and Endurance in Patients with Parkinson's Disease: Association with Swallowing, Oral Phase Efficiency, Meal, Diet Type and Malnutrition Risk.","authors":"Francesco Mozzanica, Nicole Pizzorni, Daniela Ginocchio, Sarah Feroldi, Federica Bianchi, Micol Castellari, Gabriele Mora, Marco Gitto, Federico Ambrogi, Antonio Schindler","doi":"10.1007/s00455-025-10902-7","DOIUrl":"10.1007/s00455-025-10902-7","url":null,"abstract":"<p><p>Tongue motor impairment has been documented and associated with the severity of dysphagia in patients with Parkinson's disease (PD). Yet, no study investigates the relation between tongue measures and oral phase, swallowing performance during meal, and nutrition in this population. The study aims to measure maximum isometric tongue pressure (MIP) and endurance in patients with PD and to study their association with swallowing- and meal-related safety and efficiency, oral phase efficiency, diet type, and malnutrition risk. Thirty-tree patients with PD were enrolled. Tongue MIP and endurance were measured using the Iowa Oral Performance Instrument. Patients underwent a Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Meal safety and efficiency were evaluated with the Mealtime Assessment Scale (MAS), while the Test of Masticating and Swallowing Solids (TOMASS) was used to analyze oral phase efficiency. Diet type was described according to the Functional Oral Intake Scale (FOIS) and malnutrition risk was assessed using the Mini Nutritional Assessment (MNA). The median MIP was 40 kPa, while the median tongue endurance was 14 s. At univariate regression analysis, both MIP and tongue endurance were significantly (p < 0.05) associated with TOMASS, MAS, FOIS, and MNA, while a significant association with FEES was only found between MIP and the severity of residue in the pyriform sinus with liquids. In conclusion, reduced tongue strength and endurance seem to be associated with the worsening of oral phase efficiency, swallowing performance during meal, diet type and malnutrition risk, but not with pharyngeal signs of dysphagia in PD.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"708-722"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437652","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}