You searched for "dysphagia"

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From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

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...

Can laryngeal sensitivity testing predict aspiration and pneumonia in dysphagic patients?

The laryngeal adductor reflex (LAR) is characterised by brief vocal cord closure in response to laryngeal stimulation. It is important in swallowing physiology as it represents a mechanism for airway protection. The authors of this study examined whether the absence...

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...

How are swallowing and voice affected following anterior cervical discectomy and fusion (ACDF)?

Anterior cervical discectomy and fusion (ACDF) requires an anterior transcervical approach (ACA) to allow decompression of the cervical spine and nerve roots. This approach is also occasionally used for corpectomy and osteophyte removal. Key neurovascular structures related to swallowing and...

How well do different assessments of swallowing correlate with one another?

Swallowing (dys)function may be assessed by three key measures: 1. instrumental swallowing techniques such as the modified barium swallow (MBS) or videofluoroscopy; 2. functional measures of diet texture that patients can eat comfortably (usually rated by the clinician); and 3....

Help or hinder: how and why do SLTs make clinical decisions around swallowing?

Dysphagia is a relatively common consequence of stroke, with estimates between 50% and 60% of people presenting with swallowing dysfunction following stroke. It is associated with pneumonia, malnutrition and dehydration which in turn lead to increased length of hospital admission,...

Factors influencing transformation of laryngeal dysplasia to malignancy in a 10-year review

Laryngeal dysplasia has a propensity to change into malignancy, the generally reported rate of this being about 14%. In this retrospective study of 125 patients, the authors have assessed the severity of dysplasia in relation to the incidence and time...

Tricky post-laryngectomy swallows

Despite improvements in chemoradiation therapy and the adoption of organ preservation for some head and neck cancers, total laryngectomy remains the treatment often providing best survival chances for advanced laryngeal cancer. This article reviews the causes of dysphagia post-laryngectomy and...

What about the older adults?

The authors of this paper propose that significant changes in the delivery of services, including speech and language therapy management of swallowing difficulties, may be required. Among the most common causes of dysphagia in older adults are stroke, progressive neurological...

Videofluoroscopy: A Multidisciplinary Team Approach

This book places videofluoroscopy in the context of a broader, more holistic approach to the management of patients with dysphagia. It recognises that this is perhaps currently the best available tool to aid our understanding of the physiology of normal...

Do nasogastric tubes affect aspiration risk?

A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...