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At least 577 records · Page 32Linked to original sources
PubMed2000

Bedside assessment of swallowing: a useful screening tool for dysphagia in an acute geriatric ward.

AIM: Dysphagia is common in the elderly and is associated with increased morbidity and mortality. We undertook a prospective study to determine the usefulness of a simple bedside swallowing test in terms of (1) detecting previously undiagnosed dysphagia, (2) agreement of the doctor's assessment with that of the speech therapist, (3) impact on subsequent feeding modality, (4) predicting risk of subsequent pneumonia. METHOD: Patients in an acute geriatric ward who had no contra-indications to oral feeding were subjected to a bedside swallowing assessment by a geriatrician within 24 hours of admission. All patients found to be dysphagic were subsequently re-assessed by a speech therapist within 48 hours. In addition, every fifth patient deemed to have normal swallowing by the doctor was assessed by the speech therapist. RESULTS: Sixty-five patients were studied. The doctor's assessment was in very good agreement with the assessment of the speech therapist (kappa = 0.87). Patients found to have dysphagia using the doctor's assessment protocol had an increased risk of developing pneumonia during their hospitalization (relative risk R.R.: 9.9 confidence interval C.I.: 1.2-81.2). Cough on swallowing and delayed swallowing were both found to be associated with an increased risk of developing pneumonia during the period of hospitalization (R.R.: 4.2, C.I.: 1.2-14.4; R.R.: 5.3, C.I.: 1.1-26.3 respectively). CONCLUSION: A simple bedside swallowing test can be used as an effective screening tool in detecting hitherto undiagnosed dysphagia. The validity of this tool in the diagnosis of aspiration requires further investigation.

Acute Disease↗
PubMed2003

[Process of swallowing disturbance in amyotrophic lateral sclerosis--evaluation of videofluorography and respiratory function].

We investigated the process of swallowing disturbance in the patients with amyotrophic lateral sclerosis (ALS). Swallowing function of 11 patients with ALS (67.5 +/- 7.5 y.o.) was evaluated by videofluorography (VF) and swallowing part of ALS functional rating scale (FRSsw) more than 2 times during the course. Percent of forced vital capacity (%FVC) was also measured. VF measures were oral leakage, poor bolus formation, retention in oral cavity, abnormal transport to pharynx as oral stage and delayed swallowing reflex, laryngeal penetration, aspiration, nasal regurgitation, retention in valleculae and pyriform, and abnormal opening of pharyngo-esophageal segment as pharyngeal stage. FRSsw were defined as 4: normal eating habits, 3: early eating problems--occasional choking 2: dietary consistency changes, 1: needs supplemental tube feeding and 0:NPO (exclusively parental or enteral feeding). According to VF findings in the course of oral stage and pharyngeal stage, in some patients, the disturbance of oral stage preceded that of pharyngeal stage, while in the other patients, the disturbance of pharyngeal stage disturbance preceded that of oral stage, and in another patients were mixed course. There was poor relationship between the FRSsw and VF measure. Even in the patients of FRSsw 4 & 3. penetration/aspiration were found. %FVC was 70.0 +/- 17.3% in patients with FRSsw 4 & 3, 43.1 +/- 17.6% in patients with FRSsw 2 and 40.4 +/- 16.2% in patients with FRS 1 & 0. In the individual course, FRSsw decreased in parallel with %FVC. We conclude that there are various course of swallowing disturbance on VF findings, the oral stage disturbance proceed, the pharyngeal stage disturbance proceed or mixed. Swallowing function deteriorate in parallel with respiratory function in ALS patients. We have to take measures against the dysphagia even in early stage.

Aged↗
PubMed2004

Transit time of swallowing after subtotal laryngectomy.

INTRODUCTION: The aim of subtotal laryngeal surgery (Cricohyoidopexy = CHP and Cricohyoidoepiglottopexy = CHEP) is to create a simplified but functional neolarynx. The neolarynx permits the passage of air, the closure of the airway, and ensures phonation through the vibration of the cricoid and arytenoid mucosa; furthermore, it allows the recovery of swallowing, optimizing the closure of the neoglottis with the movement of the remaining arytenoids. The aim of the present study was to evaluate, on a long-term basis, the efficiency of the swallowing function comparing swallowing times in CHEP and CHP with and without functional neck dissection (FND). MATERIALS AND METHODS: A radiological study was conducted on 48 patients selected from a group of 253, who underwent subtotal laryngectomies at the "G. Ferreri" Department of Otorhinolaryngology, Audiology and Phoniatrics of the University of Rome "La Sapienza". The selection of the 48 patients was carried out based on the following criteria: type of surgery, date of surgery (follow up of at least 12 months), patients who were not treated with radiotherapy before or after surgery, patients who were also examined with fibrolaryngoscopy and videofluoroscopy, patients not affected by motor deficits involving phonatory and swallowing regions (stroke, lesions of the central nervous system), negative follow up (no evidence of disease). The parameters for evaluating the functional recovery were the times the nasogastric tube and tracheotomy tube were kept in place. The functional recovery times of the groups thus formed were compared to one another Through videofluoroscopy the authors evaluated oral transit times (OTT) and pharyngeal transit times (PTT) as parameters of deglutition. RESULTS: The results consistently showed that swallowing time remains under one second as in individuals with normal swallowing functions. CONCLUSION: The study of deglutition times, conducted at least 12 months after surgery, does not show any substantial differences between CHEP and CHP with reference to pharyngeal transit and oral transit times.

Cricoid Cartilage↗
PubMedDate not supplied

Objective clinical assessment of change in swallowing ability of maxillectomy patients when wearing obturator prostheses.

PURPOSE: Evaluation of treatment outcome is important in maxillofacial rehabilitation. Although eating is one of the oral functions that most strongly influences patients' quality of life, only a few reports exist on the objective assessment of swallowing for maxillectomy patients. The purpose of this study was to identify changes in the swallowing ability of maxillectomy patients when wearing obturator prostheses through the use of an objective clinical assessment. MATERIALS AND METHODS: The swallowing ability of 38 postmaxillectomy patients consecutively treated with obturator prostheses was objectively evaluated with the "water-drinking test" that was developed for the assessment of dysphagia patients after cerebrovascular disease. In this test, the subjects were instructed to drink 30 mL of water in one swallow. The profile was evaluated with the combination of the time required for drinking the water and the incidence of cough reflex. Statistical analysis was performed using the Wilcoxon signed-rank test, the paired t test, and the Chi-square test with StatView 5.0 for the Macintosh. RESULTS: Performance improved significantly when the patients wore prostheses (P = .0026, Wilcoxon signed-rank test). The mean drinking times without and with prostheses were 8.2 +/- 6.3 s and 5.0 +/- 3.5 s, respectively. Drinking time was shortened significantly when the prosthesis was worn (P = .0002, paired t test). The assessment of behavior and episodes revealed that the swallowing ability of the maxillectomy patients was significantly improved when a prosthesis was worn (P = .0002, Chi-square test). CONCLUSION: The swallowing ability of maxillectomy patients was quantitatively and qualitatively improved with obturator prostheses.

Aged↗
PubMed1987

Swallowing disorders in closed head trauma patients.

Fifty-three closed head trauma patients with dysphagia were examined videofluorographically to determine the specific nature of their swallowing disorder. Eighty-one percent of the patients exhibited a delayed or absent swallowing reflex while approximately 50% of the patients suffered from reduced tongue control, and 33% had reduced peristalsis. Laryngeal disorders and cricopharyngeal dysfunction occurred in a small number of patients. The average head trauma patient exhibited more than one swallowing motility problem. Twenty patients aspirated, with delayed or absent swallowing reflex as the most common etiology for the aspiration. Many of these patients did not produce a reflexive cough during or after they had aspirated material into their airway. For this reason, and since the pharyngeal stage of the swallow is extremely difficult to assess with presently available bedside techniques, videofluorographic evaluation becomes an invaluable tool for identification of the precise nature of the swallowing disturbance, the presence of aspiration, and the etiology of the aspiration.

Adult↗
PubMedDate not supplied

[Electrophysiologic study of the cerebral control of swallowing].

Swallowing dominant, created by serial pouring of water into rabbit's mouth cavity was tested in after-action from water supply. As a result of summation in the dominant focus of excitations elicited by stimuli of various modalities, swallowing took place. The study of swallowing dominant revealed by its stimulus which elicits its own unconditioned reflex (blinking), has shown that temporary feedback is characteristic for the dominant as well as for the conditioned reflex. Summation in the swallowing center during dominant testing by stimulation of the eye cornea takes place without conjugated inhibition of the blinking center. During discrete pouring of water into the animal's mouth, evoked potentials appear in the cortical-subcortical structures of the swallowing center. Identical potentials appear in corresponding structures before the summation swallowing. Appearance of these potentials in the electric activity of the dominant focus testifies to its readiness for summation.

Animals↗
PubMed1995

[Reduction in frequency of pneumonia after stroke, following programmed swallowing evaluation].

Aspiration pneumonia is a frequent complication of cerebrovascular accidents (CVA). It occurs mainly in those with post-CVA swallowing disorders, which can be diagnosed by bedside swallowing evaluation. Evaluation is based on observation of components of the oral and pharyngeal stages of swallowing a drink of 50 ml of clear liquid. Changing the consistency of the diet and the mode of swallowing, following its evaluation, can reduce significantly the frequency of post-CVA aspiration pneumonia. In 180 patients admitted for stroke rehabilitation, aspiration pneumonia occurred in 10% and swallowing disorders were found in 28%. Planned swallowing evaluation followed by the above regimen was associated with a gradual reduction of pneumonia from 16% in the first group of 60 patients to 3% in the second group of 60; and of patients with dysphagia, from 27% in the first group to none in the second.

Cerebrovascular Disorders↗
PubMed1995

[Problems when swallowing tablets. A questionnaire study from general practice].

Dysphagia, or difficulty in swallowing tablets, may greatly affect compliance. This report presents the results of our survey, which was undertaken to determine the proportion of a general practitioner's patient population who had difficulty in swallowing tablets, and to identify the reasons for the difficulty. 6,158 questionnaires were received from patients who consulted a general practitioner. More than 1/4 (26%) of the total patient population (or 1,576) said they had problems in swallowing tablets. A prominent complaint was the size of the tablet, followed by the surface, form and taste of the tablet. Twice as many women as men experienced swallowing problems. Elderly patients (> 70 years) had less difficulty than younger patients when taking tablets. To achieve good compliance and optimal pharmacotherapy, it is important for medical practitioners and pharmaceutical personnel to be aware of the general problems connected to swallowing tablets, to enable them to select the correctly formulated drug for their patients. New and novel oral drug formulations, such as tablets that dissolve in seconds on the tongue without water, may alleviate the problem of swallowing tablets. They offer substantial advantages over ordinary tablets, are more convenient to administer, and enhance the potential for improved compliance in patients who experience difficulty in taking tablets.

Adolescent↗
PubMed1993

Solid bolus swallowing in the radiologic evaluation of dysphagia.

Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is usually not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important.

Adult↗
PubMed1993

Effect of age and bolus variables on the coordination of the glottis and upper esophageal sphincter during swallowing.

We studied 1) the effect of age and bolus variables on a) the coordination of deglutitive vocal cord adduction and upper esophageal sphincter (UES) relaxation and b) the duration of deglutitive vocal cord adduction; 2) the effect of the presence of a manometric catheter across the UES on the deglutitive glottal function; and 3) the temporal relationship between deglutitive vocal cord closure and swallow-induced apnea. We studied 10 young (23 +/- 2 yr) and 10 healthy elderly (73 +/- 2 yr) volunteers by concurrent videoendoscopy, UES manometry, respirography, and submental surface electromyography. In both groups the onset of vocal cord adduction preceded the onset of UES relaxation, deglutitive apnea, and submental electromyogram swallowing signal. In both groups, bolus volume and temperature did not have any significant effect on the duration of deglutitive vocal cord adduction. In both young and elderly volunteers, water swallows, compared with dry swallows, significantly shortened the interval between the onset of deglutitive vocal cord adduction and the onset of UES relaxation. In conclusion, coordination between deglutitive glottal and UES function, as well as the duration of deglutitive vocal cord adduction, is preserved in the elderly. Bolus volume and temperature do not have a modulatory effect on the duration of vocal cord closure, but water swallow shortens the interval between the onset of glottal closure and UES relaxation. This shortened interval may contribute to the safety of the airway during swallowing of liquid volumes.

Adult↗
PubMed1997

Speech and swallowing rehabilitation for head and neck cancer patients.

Head and neck cancer and its treatment frequently cause changes in both speech and swallowing, which affect the patient's quality of life and ability to function in society. The exact nature and severity of the post-treatment changes depend on the location of the tumor, the choice of treatment, and the availability and use of speech and swallowing therapy during the first 3 months after treatment. This paper reviews the literature on speech and swallowing problems in various types of treated head and neck cancer patients. Effective swallowing rehabilitation depends on the inclusion of a video-fluorographic assessment of the patient's oropharyngeal swallow in the post-treatment evaluation. Pilot data support the use of range of motion (ROM) exercises for the jaw, tongue, lips, and larynx in the first 3 months after oral or oropharyngeal ablative surgical procedures, as patients who perform ROM exercises on a regular basis exhibit significantly greater improvement in global measures of both speech and swallowing, as compared with patients who do not do these exercises.

Deglutition↗
PubMedDate not supplied

Swallowing performance after radiotherapy for squamous cell carcinoma oesophagus.

OBJECTIVE: To consider assessment of swallowing performance status as an alternative to survival in reporting results of treatment in patients with carcinoma oesophagus. METHODS: Twenty five patients of squamous cell carcinoma of oesophagus treated with radiotherapy were evaluated clinically, radiologically and endoscopically, to assess their response to treatment. RESULTS: Two months after radiotherapy, 10 of 25 patients had swallowing score-1. During radiotherapy, oesophagitis involving normal oesophagus and diseased segment was seen in 64% of cases. Fifty six percent of patients developed stricture (24% malignant, 32% benign). At the end of two years, only five patients were alive, two with swallowing score of 2, two with swallowing score of 3 and one with swallowing score of 4. CONCLUSION: As the overall survival in carcinoma oesophagus is poor, the short term criteria for assessing the response of treatment should be swallowing performance status. Radiotherapy treatment can provide substantial palliation for patients debilitated by dysphagia.

Aged↗
PubMedDate not supplied

[Swallowing apnea in adults].

We have studied the swallowing apnea in 66 persons. Five were laryngectomized. We analysed 1916 breathing/swallowing correlation charts, 109 in laryngectomized and 1807 in not laryngectomized persons. The correlation charts were done using a piezoelectric and thermistor register coupled to a manometric system developed by Synetics Medical interfaced to a microcomputer running software Polygram upper 4.21. Our observation allows us to conclude that: 1. the swallowing apnea has not the same reflex path of the breathing interruption that occurs when a foreign body stimulates the laryngeal receptors; 2. the swallowing apnea installation is not dependent on the laryngeal structures; 3. the swallowing apnea and rima glottidis closure, that occur in the same moment, are correlated phenomena, but are a distinct part of the airway protective mechanisms; and 4. even though the swallowing apnea can occur in every moment of the breathing cycle, it occurs more frequently at the end of expiratory and beginning of the inspiratory phase of breathing cycle; it is usually continued by a complementary expiration. We believe that the less lung volume is the basic condition to the establishment of the more frequent kind of swallowing apnea reflex.

Adult↗
PubMed2005

Thyroid function in nestling tree swallows and eastern bluebirds exposed to non-persistent pesticides and p, p'-DDE in apple orchards of southern Ontario, Canada.

This study examined the associated effects of pesticides and persistent residues of p,p'-DDE on thyroid function in 16-day-old tree swallows (Tachycineta bicolor) and 12-day-old eastern bluebirds (Sialia sialis). Apple orchards sprayed with pesticides in current use and reference sites were chosen for study in southern Ontario, Canada, during 2000-2001. We assessed thyroid hormone concentrations (plasma and muscle thyroxine [T4], and triiodothyronine [T3]) and the response to a challenge with thyroid stimulating hormone (TSH) as well as parameters of thyroid histology. Individual nests were exposed to as many as seven individual pesticide applications and up to five pesticide mixtures. Concentrations of p,p'-DDE in eggs from both species were highest in orchard sites, and ranged from 0.05 to 5.44 mg/kg wet weight for tree swallows, and from 0.17 to 95.4 mg/kg for eastern bluebirds. In 2000, tree swallows from sprayed orchards had elevated plasma T4 concentrations, and thyroid glands with collapsed follicles, hypertrophic epithelia, and higher follicular epithelial cells relative to chicks from reference sites. Plasma T4 concentration was positively correlated with the total number of pesticide mixtures applied during egg incubation through chick rearing. In 2001, basal plasma T3 concentration in tree swallow chicks did not differ between orchard and reference sites, though there were differences among orchards; T3 was positively correlated with total number of individual sprays applied during egg incubation through chick rearing. Tree swallows challenged with TSH showed no significant difference in thyroid hormone concentration or follicular epithelial cell height between exposure groups; however, a significantly greater proportion of chicks from reference sites were found to have thyroids with focal or diffuse hypertrophic epithelia relative to orchard chicks. In 2001, bluebirds from sprayed orchards had significantly higher T3 concentrations in response to TSH challenge; this response was positively correlated with the total number of pesticides applied during egg incubation through chick rearing.

Animals↗
PubMed2006

Chernobyl as a population sink for barn swallows: tracking dispersal using stable-isotope profiles.

Stable-isotope profiles of feathers can reveal the location or habitat used by individual birds during the molting period. Heterogeneity in isotope profiles will reflect heterogeneity in molt locations, but also heterogeneity in breeding locations, because spatial heterogeneity in molt locations will be congruent with spatial heterogeneity in breeding locations in species with high connectivity between breeding and molting sites. We used information on the congruence of spatial heterogeneity in molt and breeding location to study population processes in Barn Swallows (Hirundo rustica) from a region. near Chernobyl, Ukraine, that has been radioactively contaminated since 1986; from an uncontaminated control region near Kanev, Ukraine; and from a sample of pre-1986 museum specimens used to investigate patterns prior to the nuclear disaster at Chernobyl, from both regions. Previous studies have revealed severe reductions in Barn Swallow reproductive performance and adult survival in the Chernobyl region, implying that the population is a sink and unable to sustain itself. Female Barn Swallows are known to disperse farther from their natal site than males, implying that female stable-isotope profiles should tend to be more variable than profiles of males. However, if the Barn Swallows breeding at Chernobyl are not self-sustaining, we would expect males there also to originate from a larger area than males from the control region. We found evidence that the sample of adult Barn Swallows from the Chernobyl region was more isotopically heterogeneous than the control sample, as evidenced from a significant correlation between feather sigma13C and sigma15N values in the control region, but not in the Chernobyl region. Furthermore, we found a significant difference in feather sigma15N values between regions and periods (before and after 1986). When we compared the variances in sigma13C values of feathers, we found that variances in both sexes from post-1986 samples from Chernobyl were significantly larger than variances for feather samples from the control region, and than variances for historical samples from both regions. These findings suggest that stable-isotope measurements can provide information about population processes following environmental perturbations.

Aging↗
PubMed2005

Reproductive success and contaminants in tree swallows (Tachycineta bicolor) breeding at a wastewater treatment plant.

The uptake and effects of contaminants were measured in the insectivorous tree swallow (Tachycineta bicolor) at a wastewater treatment site. The study examined reproductive, immunological, and growth endpoints in tree swallows exposed to chlorinated hydrocarbon contaminants and to 4-nonylphenol in wastewater lagoons at the Iona Wastewater Treatment Plant, Vancouver (BC, Canada). Clutch size was significantly lower in tree swallows breeding at Iona Island in 2000 and 2001 compared to the reference site. In 2000, fledging success was significantly lower and mean mass of nestling livers was significantly higher in the tree swallows breeding at the Iona Island Wastewater Treatment Plant. Additional factors that may influence reproductive success, such as parental provisioning and diet composition, did not differ significantly between sites. Levels of 4-nonylphenol detected in sediment and insects were elevated at the Iona Island Wastewater Treatment Plant (2000: lagoon sediment 82,000 ng/g dry wt, insects 310 ng/g wet wt; 2001: lagoon sediment 383,900 ng/g dry wt, insects 156 ng/g wet wt) compared to the reference site (2000: pond sediment 1,100 ng/g dry wt, insects not sampled; 2001: pond sediment 642 ng/g dry wt, insects 98 ng/g wet wt). These results indicate that tree swallows might be a useful indicator species for exposure to 4-nonylphenol at wastewater treatment sites: however, further work is necessary to determine the extent of uptake and effects of 4-nonylphenol in riparian insectivorous birds.

Animals↗
PubMed2000

Swallowing function in patients with head and neck cancer prior to treatment.

OBJECTIVE: To define the site-specific swallowing dysfunctions of patients with head and neck cancer with respect to tumor site and stage by, videofluoroscopic oropharyngeal motility (OPM) study prior to initiation of treatment. DESIGN: Retrospective survey. SETTING: Academic university institution. PATIENTS: A consecutive sample of 79 patients with stage III or IV head and neck cancer without prior treatment or tracheotomy. Patients were divided into groups according to tumor site: oral cavity (n = 7), oropharynx (n = 27), larynx (n = 24), and hypopharynx (n = 10). Patients with sinonasal, nasopharyngeal, and unknown primary carcinomas served as the comparison group (n = 11). INTERVENTION: All patients underwent OPM study prior to treatment. MAIN OUTCOME MEASURES: Parameters of swallowing function, including oral impairment, pharyngeal impairment, cervical esophageal impairment, aspiration, and Swallowing Performance Status Scale (SPSS) score (a global measure of swallowing function) were extracted from the pretreatment OPM study and analyzed with reference to tumor site, T stage, and overall stage. The relations between tumor site and area or degree of dysfunction, and between stage of disease and area or degree of dysfunction were analyzed using chi2 and Fisher exact tests. RESULTS: Aspiration status, cervical esophageal impairment, and pharyngeal impairment examined as a function of disease site showed statistically significant differences between groups, with laryngeal and hypopharyngeal sites revealing the most severe dysfunctions. The SPSS score did not correlate with tumor site, T stage, or overall stage. Other OPM parameters analyzed as a function of T stage and overall stage revealed no consistent patterns. CONCLUSIONS: Hypopharyngeal and laryngeal disease sites have a high degree of pretreatment functional impairment. The SPSS score is a good global measure of swallowing dysfunction. In addition, significant site-specific dysfunctions are found when the OPM study is analyzed via its separate parameters. It is therefore critical that posttreatment function is compared with baseline pretreatment dysfunction.

Adolescent↗
PubMed2002

Swallowing outcomes following laryngectomy and pharyngolaryngectomy.

OBJECTIVES: To determine the incidence of dysphagia (defined as the inability to manage a diet of normal consistencies) at hospital discharge and beyond 1 year postsurgery and examine the impact of persistent dysphagia on levels of disability, handicap, and well-being in patients. DESIGN: Retrospective review and patient contact. SETTING: Adult acute care tertiary hospital. PATIENTS: The study group, consecutively sampled from January 1993 to December 1997, comprised 55 patients who underwent total laryngectomy and 37 patients who underwent pharyngolaryngectomy with free jejunal reconstruction. Follow-up with 36 of 55 laryngectomy and 14 of 37 pharyngolaryngectomy patients was conducted 1 to 6 years postsurgery. MAIN OUTCOME MEASURES: Number of days until the resumption of oral intake; swallowing complications prior to and following discharge; types of diets managed at discharge and follow-up; and ratings of disability, handicap, and distress levels related to swallowing. RESULTS: Fifty four (98%) of the laryngectomy and 37 (100%) of the pharyngolaryngectomy patients experienced dysphagia at discharge. By approximately 3 years postsurgery, 21 (58%) of the laryngectomy and 7 (50%) of the pharyngolaryngectomy patients managed a normal diet. Pharyngolaryngectomy patients experienced increased duration of nasogastric feeding, time to resume oral intake, and incidence of early complications affecting swallowing. Patients experiencing long-term dysphagia identified significantly increased levels of disability, handicap, and distress. Patients without dysphagia also experienced slight levels of handicap and distress resulting from taste changes and increased durations required to complete meals of normal consistency. CONCLUSIONS: The true incidence of patients experiencing a compromise in swallowing following surgery has been underestimated. The significant impact of impaired swallowing on a patient's level of perceived disability, handicap, and distress highlights the importance of providing optimal management of this negative consequence of surgery to maximize the patient's quality of life.

Adult↗