Journal Reviews
Does the appearance, texture, and flavour of food affect how we swallow?
Texture modification and the use of thickened fluids are well-known strategies used to facilitate swallowing in people with dysphagia. However, some controversy exists around thickeners and their possible negative impact on hydration and medication absorption. This paper considers other properties...
Videofluoroscopic swallowing studies: balancing risks and benefits
Videofluoroscopic swallow studies (VFSS) are an important part of the diagnostic toolkit and arguably the current gold-standard for assessing swallow biomechanics and diagnosing dysphagia. However, the procedure does involve exposure to radiation, and any clinician requesting this should be able...
How do objective ratings of swallowing compare with patient-reported dysphagia QOL measures in the head and neck cancer population?
Swallowing may be assessed by a comprehensive battery of tools including instrumental/objective assessments, clinician-rated measures and patient-reported measures. The authors of this paper use secondary analysis to explore concordance between videofluoroscopy and a patient-reported dysphagia quality of life (QOL) measure....
Resolving dysphagia – can we distinguish mild dysphagia from no dysphagia?
Many patients with dysphagia following neurological events can and do experience a resolution of their swallowing difficulties, sometimes without any intervention. However, it is challenging for clinicians to distinguish mild dysphagia from no dysphagia. The question of where to draw...
Predicting the nature of swallowing deficits caused by surgical resection of the tongue?
Patients treated surgically for cancer of the tongue are expected to have difficulty in eating, drinking and swallowing. The authors of this paper report on a cohort of 106 patients in their practice who had surgical resection as primary treatment....
All videoswallows are not performed equally…
Videofluoroscopy is one of the main instrumental tools used to assess swallowing biomechanics and physiology. In the UK, it is mainly within the remit of speech and language therapists (SLT) to perform videoswallows but there is considerable variability in both...
Cuff up or cuff down; to occlude or not to occlude? What effect does tracheostomy tube modification have on swallowing outcomes?
Dysphagia is commonly seen in patients with tracheostomy. The current global pandemic has increased interest in the impact of a tracheostomy on swallowing outcomes. This systematic review is therefore a timely addition to the literature and a useful read for...
Dysphagia following intubation during the COVID-19 pandemic
Dysphagia is a known sequela of mechanical ventilation and intubation. About a third of patients discharged from hospital after acute respiratory distress syndrome present with dysphagia. The authors of this review have considered the implications for patients intubated due to...
Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?
Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...
Assessing post-extubation dysphagia on the intensive care unit
The incidence of post-extubation dysphagia (PED) is reported to be about 12% in the general ICU population and around 18% in patients admitted to ICU as emergencies. PED was found to be an independent predictor of 28-day and 90-day mortality....
Who finds it hard to swallow?
Early identification of dysphagia in inpatients on acute stroke wards has been recommended as best practice guidelines in many countries. However, several institutions fail to use formal dysphagia screening protocols and rely on informal detection by nurses and doctors. This...
Are there benefits of prophylactic swallowing exercises for patients with head and neck cancer?
This randomised controlled trial aimed to establish the impact of prophylactic swallowing exercises in patients undergoing chemoradiation therapy for head and neck cancer. The primary outcome was the functional oral intake scale (FOIS), although secondary measures for feeding tube use,...