PURPOSE: To determine the severity of alterations on oral and pharyngeal phases of swallow and its complications in a cohort of patients of the integral rehabilitation program of the Teleton University Hospital. To characterize the study population, according to type and severity of dysphagia.
METHODS: Cohort study from May 2005 through October 2006. 111 patients with neurological and muscular diseases compromising head or neck structures underwent a standardized clinical and, when indicated, endoscopic evaluation of swallow with sensory test. Endoscopic test protocol included evaluation of laryngeal reflex, swallow of solids, semisolids, thick and thin liquids foods. The retro-prospective follow-up allowed pneumonia incidence determination.
RESULTS: Median age: 52 years old (range: 15–82). 51% had cerebrovascular diseases, 13% had neurodegenerative diseases, 12% had CNS trauma and 5% CNS neoplasia. 82% had oropharyngeal dysphagia, of which 62% had findings consistent with compromise of the pharyngeal phase of swallow. Findings on the endoscopic test included: Laryngeal reflex compromise on 67%. Laryngeal penetration of bolus: 40% with solids, 65% with thick liquids and 90% with thin liquids. Aspiration: 25% with solids and thick liquids, and 70% with thin liquids. On those with pharyngeal dysphagia pneumonia incidence was 70%.
CONCLUSION: The prevalence of oropharyngeal dysphagia and its respiratory complications could be very high in patients with neurological or muscular compromise of head and neck organs, as was seen in this cohort. The high prevalence of oropharyngeal dysphagia and pneumonia found in this group of patients could have an important impact on their morbidity, mortality, nutritional status, respiratory complications and quality of life. The FEES-ST in this kind of patients could be a cost-effective diagnostic and therapeutic guiding strategy in order to prevent dysphagia complications.
CLINICAL IMPLICATIONS: Patients with neurological or muscular compromise of head and neck structures should be routinely evaluated by standardized clinical instruments and endoscopic or videofluoroscopic evaluation of swallow.
DISCLOSURE: Luis Giraldo, No Financial Disclosure Information; No Product/Research Disclosure Information