Abstract
IntroductionSarcoidosis is a chronic granulomatous disease of unknown aetiology and laryngeal involvement is seen in a small percentage of cases. Dysphagia is a common but under-reported symptom. Little is known about how dysphagia typically presents or is managed in the context of this fluctuating disease. We present our case series using an SLT-led model of assessment and management.MethodsA literature search was conducted for any articles that reported both laryngeal sarcoidosis and dysphagia. We then analysed a case series of laryngeal sarcoidosis patients treated at Charing Cross Hospital. We report on multidimensional swallowing evaluation and rehabilitative interventions.ResultsSeventeen papers report both laryngeal sarcoidosis and dysphagia, with only one paper giving details on the nature of the dysphagia and the treatment provided.In our case series (n = 7), patients presented with FOIS Scores ranging from 5 to 7 pre-operatively (median = 6). Aspiration (median PAS Score = 6 and Range = 3–8) and pharyngeal residue were common. Sensory issues were also prevalent with most unaware of the extent of their difficulties. Management interventions included safe swallowing advice, compensatory strategies, exercises and close surveillance given their potential for repeated surgical interventions.ConclusionLaryngeal sarcoidosis is a rare condition. Dysphagia is under-reported and our experience highlights the need for specialist dysphagia intervention. Further research is required to understand dysphagia management requirements in the context of this fluctuating disease process.
Highlights
Sarcoidosis is a chronic granulomatous disease of unknown aetiology and laryngeal involvement is seen in a small percentage of cases
A retrospective analysis was undertaken of laryngeal sarcoidosis patients who had been referred to a Speech and Language Therapist (SLT) for dysphagia management at Imperial from 2016 to 2019
We developed a multidimensional dashboard of swallowing measures including the Functional Oral Intake Scale (FOIS) [6], Penetration-Aspiration Scale (PAS) [7] and Langmore’s Residue Score, as part of our standard of care
Summary
Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It typically affects patients between 20 and 40 years of age and most commonly affects the lungs, lymph nodes, liver, eyes, skin, bones and nervous system [1]. Some authors suggest between 3 and 5% of cases involve the larynx, and it is usually localised to the supraglottic region [3]. It can feature as part of a systemic sarcoid disease process, or present as an isolated lesion in the larynx. Little is mentioned in the literature about how dysphagia typically presents or is managed in the context of this fluctuating disease. The authors can confirm that this is an original study
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
