Diagnosis Of Dysphagia Research Articles

Early esophageal cancer with mucosal bridging in the resting room: A case report

BACKGROUND Patients diagnosed with esophageal mucosal bridges often experience symptoms such as chest pain and dysphagia, which pose considerable challenges for endoscopic surgical interventions. CASE SUMMARY We present a case involving early-stage esophageal cancer discovered in a resting room, notable for the rare manifestation of esophageal mucosal bridging. Following a comprehensive multidisciplinary discussion and the development of a treatment strategy, we proceeded with endoscopic submucosal dissection for the patient. During the procedure, we encountered operational challenges due to the presence of a diverticulum and a partial absence of the muscularis propria. To facilitate the retraction of a portion of the resected specimen, we utilized dental floss. Ultimately, we successfully excised the entire lesion. After a three-day period of fasting with a water-only diet, subsequent iodine water cholangiography did not indicate any perforations, and the patient was advised to transition to a liquid diet. The patient was discharged five days post-operation. A follow-up endoscopy conducted three months later revealed scar-like changes in the mid-esophagus, with the patient reporting no significant discomfort. CONCLUSION In summary, although esophageal mucosal bridges are rarely documented, they should be considered in the differential diagnosis of mechanical dysphagia. Furthermore, endoscopic therapy represents a feasible approach for their management.

Five-step dynamic ultrasonographic assessment of swallowing for dysphagia

This paper presents a five-step dynamic ultrasonography (US) technique aimed at diagnosing oropharyngeal dysphagia, which encompasses the analysis of tongue-palate contact, hyoid movement, upper esophageal sphincter opening, vocal fold closure and post-swallow residue. This protocol is implemented in a sequential manner, intending to methodically evaluate the essential phases of swallowing function. By mirroring the natural process of swallowing, this sequential method may provide a full understanding of possible dysfunctions at each stage. Considering the advantages of US in dysphagia diagnosis, we believe that this method will provide clinicians with a perspective for bedside dysphagia evaluation.

Outcomes for infants with BRUE diagnosed with oropharyngeal dysphagia or gastroesophageal reflux disease: a multicenter study from the Pediatric Health Information System Database.

We aimed to determine the prevalence of gastroesophageal reflux disease (GERD) and oropharyngeal dysphagia as explanatory diagnoses, risk factors for acid suppression treatment, and risk factors for repeat hospital visit in infants hospitalized after brief resolved unexplained event (BRUE) using a multicenter pediatric database. We performed a multicenter retrospective database study of infants admitted with BRUE in the Pediatric Health Information System between 2016 and 2021. Data included diagnostic testing, explanatory diagnoses, treatment with acid suppression, and related repeat hospital visits within 6months. Multivariable logistic regression models were used to determine risk factors for treatment with acid suppression and repeat hospital visit. Of 17,558 subjects admitted to 47 hospitals, 34% were given an explanatory diagnosis of GERD and 1.4% oropharyngeal dysphagia. Twelve percent were treated with acid suppression, with some centers having rates as high as 26%. Multiple factors, including most notably the GERD diagnosis, were associated with increased prescribing risk. Ten percent of subjects had repeat hospital visits. Subjects given an explanatory diagnosis of GERD (OR 1.66, 95% CI 1.48-1.86, p < 0.001) or oropharyngeal dysphagia (OR 2.13, 95% CI 1.55-2.91, p < 0.001) had increased risk for repeat hospital visit as did those treated with acid suppression. CONCLUSION: GERD as an explanatory diagnosis was associated with increased risk of repeat hospital visit, despite its conception as a benign, treatable condition. Treatment with acid suppression was common but did not prevent repeat hospitalization. Oropharyngeal dysphagia as an explanatory diagnosis was also associated with increased risk of repeat hospital visit.

Delayed Diagnosis of Dysphagia: Consider “FOSMN”

An 80-year-old lady had a history of progressive swallowing difficulty over several years with significant weight loss, but prior investigations in several medical departments proved negative. Neurological assessment noted her complaint of impaired feeling for food in her mouth and examination showed impaired corneal reflexes and facial sensory function. Blink reflex electrodiagnostic testing was consistent with a diagnosis of facial onset sensory and motor neuronopathy (FOSMN). This article raises awareness of the diagnosis, investigation and treatment of FOSMN.

Predictors of persistent symptoms in eosinophilic esophagitis after remission: fibrostenosis, eosinophilia, anxiety, and depression.

Eosinophilic Esophagitis (EoE) is a chronic inflammatory esophageal disorder, often associated with dysphagia, chest discomfort, and heartburn. There is limited information on persistent esophageal symptoms despite histologic remission (HR). We aimed to assess the prevalence and predictors of persistent esophageal symptoms in adult patients with EoE in HR. We performed a retrospective cohort study of adult EoE patients in HR (<15 eosinophils per high power field [eos/hpf]). Exclusion criteria included: no available data on symptoms, chronic opiate use, disorders of esophagogastric junction outflow on Chicago Classification version 4 diagnosis, esophageal candidiasis, erosive esophagitis, or other known cause of esophageal dysphagia besides EoE. Based on prior literature, definitions include: complete HR (<5 eos/hpf), partial HR (5-14 eos/hpf), and endoscopic fibrostenosis (rings and/or stricture). Esophageal symptoms were assessed within 2weeks of HR and categorized into the major symptoms of dysphagia, chest pain, and heartburn. Given the retrospective nature of the study, a global symptom response (absence or presence) was used. Demographics, disease history, endoscopy reports, EoE endoscopic reference score, and histology were recorded. Univariate and multivariable logistic regression analyses were performed. Eosinophil thresholds for persistent symptoms were determined using receiver operating characteristics analyses. Of 289 EoE patients in HR, 133 (46%) had esophageal symptoms: dysphagia (N = 119; 41.2%), heartburn (N = 28; 20.8%), and chest pain (N = 10; 7.5%). Significant predictors for persistent dysphagia were anxiety (adjusted odds ratio [aOR] 3.77) and endoscopic fibrostenosis (aOR 3.87). Significant predictors for persistent heartburn with or without chest pain were anxiety or depression (aOR 12.2 and aOR 11.0) and partial HR (aOR 1.17 and aOR 1.18). Threshold eosinophil counts for persistent heartburn and chest pain were 2.5 and 3.5 eos/hpf, respectively (AUC 0.71 and 0.69). We report a high prevalence of persistent esophageal symptoms in EoE patients who are in HR. Risk factors include anxiety, depression, endoscopic fibrostenosis, and partial HR. These findings can help direct patient care, including endoscopic dilation and managing psychiatric comorbidities. Targeting less than 2.5 and 3.5 eos/hpf for heartburn and chest pain may be warranted.

Methods of diagnosis and rehabilitation of dysphagia in patients with spinal cord injury: a systematic review.

Latest epidemiological metrics put a global prevalence of 20.6 million people suffering from spinal cord injury (SCI), leading to a burden of functional disability, deterioration in quality of life and reduced life expectancy. A thorough statement of diagnostic methods and treatment protocols for swallowing disorders after SCI stands as a major priority to streamline patient care and cost-sharing. Here we have provided a systematic overview of the evidence on diagnostic and rehabilitation protocols of dysphagia in the SCI population. The literature was searched in six electronic databases up to April 30th, 2024. Screening the 521 retrieved articles for inclusion criteria resulted in the selection of 43 studies that reported assessment tools and rehabilitation protocols for dysphagia in patients with SCI. Two researchers extracted the data in parallel, and inter-rater reliability (IRR) was used to estimate inter-coder agreement and then κ statistic to measure accuracy and precision. Based on PRISMA concepts and quality assessment steps, a k coefficient of at least 0.9 was obtained in all data extraction steps. All reports were assessed for risk of bias using the NIH Quality Assessment Toolkit. The study protocol was registered on PROSPERO (CRD42023449137). Dysphagia assessment methods were collected and grouped into four different macro categories (clinical assessment, rating scale, self-reported questionnaire, and instrumental assessment). It was found that the Bedside Swallow Evaluation (BSE) for the clinical assessment category (50%), the Bazaz score (32.5%) for the rating scale category, the Eating Assessment Tool-10 (EAT-10) (44.4%) for the self-reported questionnaire category, and the Videofluoroscopic Study of Swallowing (VFSS) (48.9%) for the instrumental assessment category were the most representative tools. The rehabilitation protocols described included either an early oral feeding exclusion or a consistency-modified oral intake, postural adaptations, oxygen therapy with a high-flow nasal cannula combined with indirect/direct therapy, specific exercises, and neuromuscular electrical stimulation. Methods of diagnosis and rehabilitation protocols for dysphagia in SCI patients appear inconsistent. Further rigorous studies are needed to achieve better clinical handling in SCI settings while lowering the load of patient morbidity and related healthcare costs.

Electromyography in subjects with amyotrophic lateral sclerosis and dysphagia: cross-sectional study

Introduction: neurogenic dysphagia is a set of swallowing disorders caused by diseases that affect the nervous system, such as amyotrophic lateral sclerosis. Specific complementary tests can be performed to evaluate and clarify the diagnosis, such as swallowing videoendoscopy, videofluoroscopy and surface electromyography. The present study arose from the need for greater availability of investigative methods for the early diagnosis of dysphagia. Objective: to evaluate the association between Surface Electromyography and swallowing videoendoscopy for the diagnosis of dysphagia in subjects with amyotrophic lateral sclerosis. Methods: 32 subjects participated, 16 from Group A, subjects with Amyotrophic Lateral Sclerosis. and 16 from Group B, control. Based on the quantitative data generated by the tools, Surface Electromyography and Swallowing Videoendoscopy, descriptive and inferential analyses were performed. Result: there was a strong statistical correlation between Surface Electromyography (rest to maximum voluntary contraction ratio) and Videoendoscopy of Swallowing (O’Neil swallowing scale). The correlation coefficient was r= -0.747, indicating a strong negative correlation (inversely proportional) between these variables. Conclusion: thus, there was an association between Surface Electromyography and Videoendoscopy of Swallowing for the diagnosis of dysphagia in subjects with Amyotrophic Lateral Sclerosis. Portable Surface Electromyography proved to be an important exam for the early diagnosis of neurogenic dysphagia.

Atypical Presentation and Management of Giant Tonsillolith: A Case Report and Literature Review

Abstract This report details a unique case of a 53-year-old patient presenting with dysphagia, odynophagia, and trismus in ”Sf. Apostol Andrei” County Emergency Clinical Hospital Constanta, Romania. Examination revealed a large mass within the left tonsil, prompting a differential diagnosis encompassing malignancy, abscess, and foreign body. Radiological evaluation proved challenging, as the mass mimicked a tumor on initial studies. Ultimately, CT scan confirmed the presence of a giant tonsillolith measuring an exceptional 51/23/31mm - exceeding the largest previously documented case (4.2 cm). Surgical excision under local anesthesia successfully removed the tonsillolith. This case underscores the importance of considering giant tonsilloliths in the differential diagnosis of oropharyngeal dysphagia, particularly in patients with suboptimal oral hygiene. We further emphasize the potential diagnostic challenges associated with these rare presentations and the crucial role of advanced imaging modalities. A comprehensive review of the literature regarding tonsillolith formation, diagnosis, and management is included.

Dysphagia and Dysphonia After Head and Neck Cancer.

The purpose of this work is to synthesize the latest developments in diagnosis and management of acute and late dysphagia and dysphonia in oral cavity cancer. A literature search was conducted using PubMed, Web of Science, Embase and Google Scholar in May 2024 of articles published between 2021 and 2024. Keywords in the search terms included oral cavity cancer, dysphagia, dysphonia, deglutition, swallowing, voice, oral cavity cancer treatment, oral cavity radiation, chemotherapy, dysgeusia, xerostomia, swallow preservation. Twenty-seven pertinent studies fit the inclusion criteria. The most common dysphagic complaints following head and neck cancer are trismus, xerostomia, mucositis and dysphagia. Dysphonia, change in voice is reported by half of head and neck cancer survivors. Fibrosis and neuropathy following radiation therapy to the oral cavity, tongue, oropharynx and its surrounding structures is the most common etiology of post-treatment dysphonia. Oral cavity cancers cause speech and swallowing dysfunction due to both anatomic and post-treatment changes. These sequalae can be detrimental to the quality of life of the head and neck cancer survivor. For both dysphagia and dysphonia after head and neck cancer early speech and swallow therapy with a Speech Language Pathologist are essential to restoring and maintaining function.

Dysphagia Screening in Residential Long-Term Care Settings in the Republic of Ireland: A Cross-Sectional Survey.

Dysphagia affects up to 70% of older adults living in residential long-term care settings (RLTCS) and may lead to serious complications if not identified and adequately managed. However, there is a dearth of clinical guidelines tailored to older adults at risk of dysphagia in RLTCS. An online survey consisting of 40 questions was conducted to identify dysphagia screening practices, referral patterns and interventions implemented by nurses in cases of suspected dysphagia, to quantify the number of residents with dysphagia, episodes of aspiration pneumonia in the previous year, and use of modified texture diets and fluids and explore differences between groups of RLTCS. The survey was developed using Qualtrics XM Platform and circulated via email, with one response per RLTCS sought. Data were analysed using RStudio. Of the 429 RLTCS contacted, 45 completed and returned the survey, a 10.5% response rate. Dysphagia screening practices, referral patterns, and dysphagia management interventions varied across participating RLTCS. All participants reported that they observe for signs and symptoms of dysphagia at mealtimes to identify residents at-risk of dysphagia. Ninety six percent of RLTCS reported referring residents with suspected dysphagia to speech and language therapy dysphagia services. A diagnosis of dysphagia was reported in 35.3% of residents. All participating RLTCS reported providing modified texture diets and fluids if residents had suspected dysphagia. The implementation of standardised and validated dysphagia screening protocols in RLTCS in the Republic of Ireland may be useful in supporting the identification of at-risk residents.

Narrative review of diagnosis, management and treatment of dysphagia and sialorrhea in amyotrophic lateral sclerosis.

The degenerative motor neuron disorder amyotrophic lateral sclerosis (ALS) frequently leads bulbar symptoms like dysarthria, dysphagia, and sialorrhea, in approximately one-third of cases being the initial symptom. Throughout the disease, more than two-thirds of ALS patients experience dysphagia, regardless of the region of onset. In this review, we aimed to offer an updated overview of dysphagia and sialorrhea in ALS, covering its diagnosis, monitoring, and treatment in clinical practice. Regular assessment of dysphagia and sialorrhea during each patient visit is essential and should be a standard aspect of ALS care. Early discussion of potential treatments such as high-calorie diets or percutaneous endoscopic gastrostomy (PEG) is crucial. Furthermore, this review highlights and discusses potential areas for improvement in both clinical practice and research.

Measurement Properties of Korean Version of Swallowing-Related Patient-Reported Outcome Measures: A Scoping Review

Patient-reported outcome measures (PROMs) have been studied for their application in the evaluation of patient experiences of dysphagia and swallowing-related quality of life in Korea. However, there has not been sufficient attention to these measures. This scoping review was to overview the latest evidence on swallowing-related PROMs and those measurement properties. We also performed a quality assessment for the cross-cultural adaptation of the PROMs if those were adapted in Korea. We reviewed articles published in English and Korean from their beginning through December 2023 using three electronic databases: PubMed, Embase, and Web of Science. Because this review included both the translated versions of and Korean-developed questionnaires, the cross-cultural adaptation and measurement properties of PROMs were investigated for quality assessment. We evaluated nine studies with eight PROMs in total. The cross-cultural adaptation of PROMs generally demonstrated poor quality, in terms of a lack of evidence on the translational process to adequately adapt the questionnaire items to different socio-cultural contexts. The Korean-developed questionnaires also showed poor quality of the measurement properties. This may be due to the questionnaires' early developmental stage at present. This scoping review was the first to outline the current evidence on swallowing-related PROMs in Korea. Further studies are necessary to ensure the high methodological quality of the questionnaires for dysphagia diagnosis and intervention.

Recent advances in the diagnosis and treatment of dysphagia in neurological diseases

Swallowing disorders are common in many neurological diseases, especially in stroke, Parkinson’s disease, amyotrophic lateral sclerosis, dementia, and multiple sclerosis. Neurogenic dysphagia is associated with an increased risk of death and serious complications, including aspiration pneumonia, dehydration, and malnutrition, which points to the importance of implementing recent advances in the diagnosis and treatment of swallowing disorders into neurological practice. If the initial screening for swallowing disorders is positive, further workup includes a combination of bedside tests and ancillary investigations, such as comprehensive clinical, videofluoroscopic and endoscopic swallowing evaluation. These measures allow to determine the type and degree of dysphagia severity, which is necessary for choosing the optimal therapeutic strategy. Treatment of patients with neurogenic dysphagia requires multidisciplinary approaches involving a team of specialists, including neurologists, speech and language therapists, gastroenterologists, and dietitians. Therapeutic strategy should include providing adequate nutritional support by diet modification and/or enteral nutrition through a nasogastric tube or gastrostomy, appropriate management of underlying and concomitant diseases, prevention and treatment of complications as well as rehabilitation interventions. Future directions to reduce swallowing disorders in neurological diseases will probably comprise a combination of rehabilitation measures with pharmacotherapy and non-invasive stimulation/neuromodulation. Early detection and effective treatment of dysphagia is crucial for achieving better outcomes and improving the quality of life in patients with neurological diseases.

Community Flexible Endoscopic Evaluation Of Swallowing (FEES): A Prospective Cohort Study Of Clinical, Process And Patient-Reported Outcomes

Abstract Background Dysphagia prevalence increases with age, impacts on quality of life and increases healthcare utilisation and cost (Atrill 2018). Instrumental swallowing assessment is essential for accurate diagnosis and treatment of dysphagia but can be difficult to access in the community. FEES is a gold-standard instrumental assessment delivered by speech and language therapists (SLTs). The aim of this abstract is to report clinical, process and patient-reported outcomes of participants who had a community FEES over a 6-month period. Methods A prospective cohort study recruiting adults who accessed community FEES in Ireland's Mid-West. Baseline assessment data (demographics, a range of validated tools and process data) were recorded at index visit. A structured phone interview was completed at six months. The primary outcome was the rate of medical complications potentially caused by dysphagia at follow-up. Secondary outcomes included healthcare utilisation, dysphagia severity, functional status and quality of life. Results 62 participants were recruited: mean age: 70.98 (SD=15.01), 55.4% were female. At follow-up, 27.42% reported medical complications potentially attributable to dysphagia, 27.4% had attended general practice, 3.23% attended medical assessment units, 6.45% attended emergency departments. 82.26% were diagnosed with dysphagia or modified independence: Dysphagia Outcome Severity Scale (DOSS) ≤6, (M=5.2, SD=1.53). Changes to dysphagia care plans were recommended in 60.94% of cases. There was significant difference in Functional Oral Index Scale (FOIS) scores across time, F (1.75, 106.78) = 5.38, p = 0.008. FOIS scores at 6 months (M=5.92, SD=1.50) were significantly higher than pre-FEES (M=6.42, SD=1.37). Significant differences in quality of life (EQ5D5L-VAS) scores p&amp;lt;0.001 were detected: higher scores at 6-months (M=69.35; SD=20.42) compared to index visit (M=64.52; SD=19.44). Conclusion Access to community FEES for older persons may improve outcomes by reducing the frequency of dysphagia-related complications and healthcare utilisation, improving functional swallowing status, enhancing quality of life and contribute to evidence-based dysphagia diagnosis and care planning.

The Relationship Between Poststroke Dysphagia and Poststroke Depression and Its Risk Factors.

A diagnosis of dysphagia and/or depression after stroke can impact the physical, psychological, and social welfare of stroke survivors. Although poststroke depression (PSD) and poststroke dysphagia are known to occur concurrently, there is a paucity of research that has specifically investigated their association. Therefore, we aimed to study the relationship between PSD and poststroke dysphagia during acute inpatient hospitalization and within 90 days after discharge. Furthermore, we aimed to evaluate the odds and hazard of being diagnosed with depression after stroke and estimate the time to depression diagnosis from the initial stroke diagnosis in patients with and without a diagnosis of dysphagia. Using the acute inpatient hospital data set from our previous work, we pulled additional postdischarge administrative claims data from the 2017 Medicare 5% Limited Data Set and conducted a retrospective, cross-sectional study of patients diagnosed with poststroke dysphagia and PSD. Patients diagnosed with poststroke dysphagia had 2.7 higher odds of being diagnosed with PSD and had an approximately 1.75-fold higher hazard for PSD diagnosis in the 90 days after discharge compared to patients not diagnosed with dysphagia. Risk factors for PSD included having dysphagia, being female, and having dual eligibility. Our results demonstrated a significant association between PSD and poststroke dysphagia. Additional research should further explore the impact of PSD on poststroke dysphagia.

Dysphagia Prevalence in Brazil, UK, China, and Indonesia and Dysphagic Patient Preferences.

Dysphagia is common, but there is limited information about its prevalence and patient preferences regarding dosage forms (oral solids, liquids, topical, etc.) in Brazil, China, the United Kingdom (UK), and Indonesia. We conducted an online survey of 1000 adults from each country, without any required disease, to estimate the prevalence of dysphagia in these four nations and the dosage form preferences among UK patients. A total of 36.9%, 40.5%, 54.9%, and 64.5% from the UK, Indonesia, Brazil, and China, respectively, had an Eating Assessment Tool (EAT-10) score of ≥3 (indicative of dysphagia). Only 2% of UK respondents and 5% of Brazilian respondents reported a formal diagnosis of dysphagia. Indonesian (74%) and Chinese respondents (77%) were more likely than Brazilian (52%) and UK respondents (45%) to report that their swallowing problems affected their ability to adhere to medication instructions. Liquids were the oral medication formulation most preferred by those who reported difficulty swallowing. To conclude, substantial populations have difficulty swallowing, which can translate into an access issue for medical treatment. The availability of people's preferred dosage forms may help alleviate the adherence issues associated with difficulty swallowing and the concomitant effects on health outcomes.

Clinical Diagnosis of Esophageal Dysphagia Using Transnasal Esophagoscopy: A Case Report.

The aim of the present study was three folds; (i) to correlate clinical case history with objective findings of a client presented with sternal discomfort along with odynophagia; (ii) to evaluate the cause for retrosternal discomfort using Functional Esophagoscopy (FE); and (iii) to reaffirm the Cook's (2008) algorithm for clinical diagnosis of esophageal dysphagia in single sitting using Transnasal Esophagoscopy (TNE). A 72 years old male (named 'G') visited a tertiary health care hospital with a complaint of imbalance for past 2 months. Also, had a complaint of pain while swallowing for the past 15 days along with left arm weakness (for past 2 days) and got admitted for treatment. Pertaining to swallowing, a detailed case history was taken and Fiber-optic endoscopic evaluation of swallowing (FEES) was performed to evaluate swallowing safety functions using digital swallowing workstation (KAYPENTAX, New Jersy, USA). A large growth was noticed in the lower border of esophagous using TNE in this patient. The oral, oro-pharyngeal, and pharyngeal phase of swallowing was intact. Esophageal phase of swallowing revealed reduced peristaltic movement including a mass lesion observed in client 'G' from TNE procedure. Clinical correlation of objective findings in this client corroborated well with history. Visualization studies including TNE can be used safely, comfortably in OPD basis without any anesthesia would be few advantages of TNE procedure. Even lesions at lower end of esophagus can be detected using TNE and it is concluded that the symptom retro-sternal discomfort might be clinically correlated with history and objectively determined by TNE procedure as esophageal dysphagia due to structural lesion. Also, algorithm of Cook's (2008) guides the investigation procedure quickly in a single sitting. Therefore, clinical history about patient is imperative that accurately guides further in terms of patient's care for assessment and treatment.

Ultrasound Utilization in the Diagnosis and Management of Dysphagia

Ultrasound Utilization in the Diagnosis and Management of Dysphagia

Prevalence of dysphagia following posterior fossa tumor resection: a systematic review and meta‑analysis

ObjectiveDysphagia is common in individuals who have undergone posterior fossa tumor (PFT) resection and negatively impacts on the individual’s quality of life, nutritional status, and overall health. We aimed to quantitatively synthesize data from studies of the prevalence of dysphagia following PFT resection.MethodsPubMed, Web of Science, the Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database were searched for case-control and cross-sectional studies that evaluated the prevalence of dysphagia after PFT surgery. Meta-analyses were performed to determine the prevalence of dysphagia. Subgroup and meta-regression analyses were performed to determine the sources of heterogeneity among the studies.ResultsA total of 22 studies were included, involving 20,921 cases. A meta-analysis of the random-effects model showed that the pooled global prevalence of dysphagia following PFT resection was 21.7% (95% confidence interval: 16.9–26.6). The subgroup and meta-regression analyses demonstrated that participant age (P < 0.001), assessment methods (P = 0.004), and geographical region of the study participants (P = 0.001) were sources of heterogeneity among the studies.ConclusionsDysphagia has a high prevalence following PFT resection. Individuals with PFTs who are at a high risk for dysphagia should be identified early through screening. Multidisciplinary diagnosis and treatment of dysphagia are required to improve the outcomes in the early stages after PFT resection.

Fiberoptic nasopharyngoscopic evaluation of swallowing for the detection of dysphagia in patients with stroke: a integrative review

Difficulty for swallowing, clinically defined as dysphagia, is a common manifestation in stroke patients and significantly increases the risk of clinical complications. The objective of this study was to perform a integrative review of the literature regarding the accuracy of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) for detecting dysphagia in patients with stroke. Methods: We conducted a search for articles published from 2000 to 2021 in the PubMed, Scopus, Embase, and Bireme databases. The following keywords were used: "fiberoptic endoscopic evaluation of swallowing (FEES)" and "stroke". Results: It was identified 23 articles that utilized fiberoptic endoscopic evaluation of swallowing (FEES) to screen stroke patients for dysphagia. The overall sensitivity and specificity of fiberoptic endoscopic evaluation of swallowing (FEES) ranged from 55.9% to 100%. Conclusions: The standardization of specific protocols for the diagnosis of dysphagia in stroke patients is necessary, both in clinical tests and fiberoptic endoscopic evaluation of swallowing (FEES), as special care is essential for these patients given their unique clinical characteristics.