Gag Reflex Research Articles

Spinal Muscular Atrophy Type II: Anesthetic Challenges and Perioperative Management

AbstractSpinal muscular atrophy (SMA) is a group of genetic diseases that cause weakness and wasting in voluntary muscles of infants and children and more rarely in adults. It is caused by inadequate production of a protein called survival motor neuron (SMN) protein coded by SMN1 gene on chromosome 5. Anesthetic challenges in patients of SMA include their sensitivity toward induction agents such as thiopental, opioids, muscle relaxants, and their incomplete reversal with anticholinesterases. They also have weakness of respiratory muscles and inadequate laryngeal reflexes, which make them prone to aspiration. Although spinal and epidural anesthesia have been described in adults with SMA, but general anesthesia in these patients is very challenging. In this case, successful perioperative management of such a patient scheduled for correction of dislocated hip has been described.

Infantile Ascending Hereditary Spastic Paralysis with Extrapyramidal and Extraocular Manifestations Associated with a Novel ALS2 Mutation.

Infantile Ascending Hereditary Spastic Paralysis with Extrapyramidal and Extraocular Manifestations Associated with a Novel ALS2 Mutation.

Comparative Efficacy of the KTP Laser and Cold Steel in Office-Based Surgery for Oropharyngeal Papilloma.

Objective: This study aims to compare the efficacy of the potassium-titanyl-phosphate (KTP) laser and cold steel surgery in treating oropharyngeal papilloma. Methods: Between 2017 and 2020, we enrolled 242 patients with oropharyngeal papilloma who were treated with either the KTP laser (n = 160) or cold steel surgery (n = 82). Patient charts were reviewed for demographic data (age and gender), pathology, anatomical location of lesions, operative duration, pain rating, residual disease, and recurrence. Results: The oropharyngeal papillomas were successfully removed in all patients, except one with a significant pharyngeal reflex. There was no significant difference in the average time for lesion resection between KTP laser and cold steel group (18.11 ± 13.96s vs 19.43 ± 16.91s, P > .05). However, all patients who underwent cold steel surgery experienced bleeding during the operation and required postoperative observation (about 20min), making the total procedure time longer than that of the KTP laser procedure, which did not cause any intraoperative bleeding or require postoperative observation. After KTP laser treatment, the pain rating was .49 ± .98, whereas after cold steel surgery, it was .74 ± 1.12 (P = .058). Twenty-five samples were sent for human papillomavirus (HPV) testing, and one tested positive for both HPV 6 and 11 strains, while another tested positive for HPV 16. No residual disease or recurrence was observed at the treatment sites after a long period of follow-up (M = 15.35 ± 10.79mo; range = 6-39mo). Conclusion: The KTP laser provided a better hemostasis effect and a good surgical field of vision during the operation, allowing the surgeon to complete the procedure in less time. No significant difference in terms of pain rating, incision recovery, and postoperative recurrence between the KTP laser treatment and cold steel surgery.

Comparative effectiveness of lidocaine sprays between sitting and supine position for patients undergoing upper gastrointestinal endoscopy: a prospective randomized controlled trial.

Topical pharyngeal anesthesia has improved esophagogastroduodenoscopy (EGD) efficiency with smooth insertion, reducing pain and discomfort. Lidocaine spray is one of the safe and widely used methods. In practice, the patients walk, sit in a wheelchair, or lie on a trolley bed, and the lidocaine sprays are applied to those in sitting or supine positions for pre-endoscopic preparation. Although there is no current guidance technique, this study aims to compare the effects of lidocaine sprays between sitting (Group A; Gp A) and supine positions (Group B; Gp B) for patients undergoing unsedated EGD. This study was a single-center prospective randomized controlled trial. Unsedated EGD patients were randomly allocated the lidocaine spray in sitting or lidocaine spray in the supine position. Lidocaine spray treatments were significantly different in the gag reflex (NRS; Gp A: 1.28 ± 0.67, Gp B: 1 ± 0.63, p = 0.0003), ease of esophageal instrumentation (NRS; Gp A: 7.68 ± 0.91, Gp B: 7.95 ± 0.66, p = 0.0042), and pain score (NRS; Gp A: 5.16 ± 2.08, Gp B: 4.53 ± 1.93, p = 0.0059). When considering modified Mallampati classification (MMC), MMC classes III and IV were significantly different in the same direction but MMC classes I and II were not. The technique of spraying in the supine position was associated with less gagging, less pain, and easier esophageal instrumentation, especially in patients with MMC classes III and IV.

The short-latency R1 response of the electrical laryngeal adductor reflex contributes to airway protection by initiating glottic closure

ObjectiveThe fundamental role of the short-latency (R1) laryngeal adductor reflex (LAR) response remains unclear with conflicting reports in the literature. This study's primary aim was to objectively determine whether the bilateral R1 response, which was elicited by electrical stimulation of the supraglottic mucosa, triggered bilateral glottis closure. MethodsVideo recording of the LAR in a prospective case series of patients undergoing trans-oral rigid laryngoscopy. The LAR was elicited by electrical stimulation of supraglottic mucosa. The LAR R1 and long-latency (R2) responses in laryngeal adductor musculature were correlated with mechanical vocal fold (VF) adduction in a time-locked manner. A high-speed camera recording 1057 frames per second was used to determine where in the LAR contractile closure the electrical R1 component occurred. ResultsFive patients were prospectively enrolled. The R1 response was present in all trials for all patients. The R2 response was recorded in four patients (80%). As assessed by the latency of the R1 response, electrical activation of the adductor muscles always preceded the mechanical onset of VF movement. VF adduction began near the middle of the R1 response in all trials for all patients. The R2 response of the LAR began after visible VF adduction for all patients. ConclusionsThis study provides the first objective evidence that the bilateral R1 response of the electrically elicited LAR is the electrical event that initiates reflex airway closure. SignificanceThese results suggest that under total intravenous anesthesia, the larynx preserves its capacity to elicit a LAR, thereby maintaining some protective functions that can prevent airway penetration.

Advancing Laryngeal Adductor Reflex Testing Beyond Sensory Threshold Detection

Flexible endoscopic evaluation of swallowing with sensory testing (FEESST) is a promising clinical tool to assess airway integrity via the laryngeal adductor reflex (LAR). The current clinical protocol relies on sensory threshold detection, as relatively little is known about the motor response of this sensorimotor airway protective reflex. Here, we focused on characterizing normative LAR motion dynamics in 20 healthy young participants using our prototype high-pressure syringe-based air pulse device and analytic software (VFtrack™) that tracks vocal fold (VF) motion in endoscopic videos. Following device bench testing for air pulse stimulus characterization, we evoked and objectively quantified LAR motion dynamics in response to two suprathreshold air pulse stimuli (40 versus 60mmHg), delivered to the arytenoid mucosa through a bronchoscope working channel. The higher air pressures generated by our device permitted an approximate 1cm endoscope working distance for continual visualization of the bilateral VFs throughout the LAR. Post hoc video analysis identified two main findings: (1) there are variant and invariant subcomponents of the LAR motor response, and (2) only a fraction of suprathreshold stimuli evoked complete glottic closure during the LAR. While the clinical relevance of these findings remains to be determined, we have nonetheless demonstrated untapped potential in the current FEESST protocol. Our ongoing efforts may reveal LAR biomarkers to quantify the severity of laryngeal pathology and change over time with natural disease progression, spontaneous recovery, or in response to intervention. The ultimate goal is to facilitate predictive modeling of patients at high risk for dysphagia-related aspiration pneumonia.

The Gag Reflex: A Hurdle in Dentistry– Literature Review

Gagging reflex poses a hurdle in numerous dental procedures. It causes discomfort for the patient, extended procedure time for the clinician, compromised quality of treatment and along with a lot of physiological discomfort for both. The normal gag reflex is protective in nature, but few individuals elicit extreme response, leading to problems during the treatment procedures. It is extremely important for the clinician to identify the cause and severity of the condition so that it can be decided whether the patient can handle standard treatment techniques or whether alternative methods must be considered. There is no universal solution for successfully managing the gagging patient. Various modalities can be used according to the doctor’s assessment and patient’s conditions in order to control the gag reflex so that the patient can be comfortable and cope with the dental treatment. A wide range of management solutions are available, and many cases need a combination of therapeutic procedures. The main aim of the present article is to comprehensively report the clinical significance, etiology, symptoms and various management approaches used during prosthodontic treatments.

Influence of Pharyngeal Anaesthesia on Post-Bronchoscopic Coughing: A Prospective, Single Blinded, Multicentre Trial.

Background: Local anaesthesia of the pharynx (LAP) was introduced in the era of rigid bronchoscopy (which was initially a conscious procedure under local anaesthetic), and continued into the era of flexible bronchoscopy (FB) in order to facilitate introduction of the FB. LAP reduces cough and gagging reflex, but its post-procedural effect is unclear. This prospective multicentre trial evaluated the effect of LAP on coughing intensity/time and patient comfort after FB, and the feasibility of FB under propofol sedation alone, without LAP. Material and methods: FB was performed in 74 consecutive patients under sedation with propofol, either alone (35 patients, 47.3%) or with additional LAP (39 patients, 52.7%). A primary endpoint of post-procedural coughing duration in the first 10 min after awakening was evaluated. A secondary endpoint was the cough frequency, quality and development of coughing in the same period during the 10 min post-procedure. Finally, the ease of undertaking the FB and the patient’s tolerance and safety were evaluated from the point of view of the investigator, the assistant technician and the patient. Results: We observed a trend to a shorter cumulative coughing time of 48.6 s in the group without LAP compared to 82.8 s in the group receiving LAP within the first 10 min after the procedure, although this difference was not significant (p = 0.24). There was no significant difference in the cough frequency, quality, peri-procedural complication rate, nor patient tolerance or safety. FB, including any additional procedure, could be performed equally well with or without LAP in both groups. Conclusions: Our study suggests that undertaking FB under deep sedation without LAP does to affect post-procedural cough duration and frequency. However, further prospective randomised controlled trials are needed to further support this finding.

803 Management of An Intra-Oral Resection with Integra® Dermal Regeneration Template – Worth A Bite?

Abstract Introduction There are a spectrum of treatment options available for reconstruction of oral mucosal defects including secondary healing, skin grafts, local flaps and microvascular free flaps. We present the use of an alternative intra-oral reconstruction with Integra® Dermal Regeneration Template. Case Report An 85-year-old patient with a severe gag reflex and history of oral cancer presented with biopsy proven severe dysplasia of the right palate extending to the hamular notch. She was treated with wide local excision, extraction of teeth, buccal fat pad advancement for closure of an oral-antral communication and placement of Integra® Dermal Regeneration Template. Discharge was possible the same day as the patient was able to eat and had minimal pain. Discussion Integra® Dermal Regeneration Template is a bilayer wound matrix consisting of silicone in the outer layer with bovine collagen and glycosaminoglycan from shark cartilage in the inner layer. Oral cancer predominantly affects the older population, and this method can reduce surgical time, remove donor site pain, reduce post-operative pain and avoid use of a cover plate where a strong gag reflex was present. The area heals quickly and aids quick restoration of oral function. Conclusion Integra® Dermal Regeneration Template has been used for head and neck defects with good outcomes. It is being increasingly used intra-orally with good outcomes, suggesting a further application of the material with advantages over traditional techniques in specific patient groups.

The Effectiveness of Adenosine in Treating the Acute Attacks of Supra-ventricular Tachycardia

Background: Adenosine is a natural adenine nucleoside available endogenously that decreases heart beat by blocking atrioventricular (AV) node transiently so that extend the duration of conduction in (AV) node when injected intravenously. It has a curative value in the conversion of majority of supraventricular tachycardia (SVT) to sinus rhythm. In order to evaluate the adenosine in the management of arrhythmias we conduct this study. Objective: This study was conducted to evaluate the safety and efficacy of intravenous adenosine therapy for treatment of (SVT), to determine the optimal adenosine dose effective in (SVT), and to determine the underlying conditions affecting the effective dose. And to evaluate the effectiveness of vagal maneuvers in terminating of spontaneous SVT patients and methods: A cross-sectional study conducts in a group consist of 69 patients ranged from 23-70 years old admitted to the Coronary care unit in Azadi Teaching Hospital ,in Kirkuk city, from July 2014 to June 2016. The diagnosis of (SVT) was made by present of tachycardia which is of narrow complex with a heart beat rate greater than 140 beats/ min by 12 leads chest electrocardiography (ECG). In patients who are hemodynamically stable, vagal maneuvers were carried out initially in the form of carotid sinus massage, gag reflex and Valsalva maneuver, if this failed intravenous administration of adenosine as recommended doses were preformed. If three doses of adenosine boluses were unsuccessful to convert the arrhythmia, patients were managed with other available antiarrythmias or managed with direct electrical cardio version (DC). In unstable patients were managed with (DC). Results: Of 69 included patients, diagnosed as (SVT), M: F ratio was 1:2.1. Their age ranged from 23 years to 70 years with mean age of 57 years. Vagal maneuvers (VM) resulted in restoration of sinus rhythm (SR) in 8patients (7.6%). Out of 57 episodes of (SVT), Adenosine was effective in reverting 51 episodes of SVT to sinus rhythm (89.5%). Of those converted, 18 required a single dose (6mg) (31.6%), fifteen required one additional (12mg) dose (26.3%), and another 18 required two additional doses (81mg) (31.6%).four patients were hemo-dynamically unstable (systolic blood pressure <90 mm Hg) which required (DC). Six patients (10.5%) not responding to full adenosine dose(81mg), started treatment with other medication, 1 with verapamil, 4 with amiodarone, and1 with digoxin. All of them were successfully treated. Conclusions: Adenosine is an effective medicine in treating (SVT) in those patients in whom vagal maneuvers has unsuccessful. It demonstrates a high rate of success in terminating acute attack of SVT. A higher dose may be required in majority of patients specially

Acupuncture and Transcutaneous Electrical Acupoint Stimulation Do Not Suppress Gag Reflex.

Objective: Gagging is a problem for many dental patients, as well as patients undergoing medical procedures, such as intubation. Research to date on the gag reflex has been limited by a lack of objective measures for measuring this reflex. Materials and Methods: A validated quantitative method was used to measure if acupuncture or transcutaneous electrical acupoint stimulation (TEAS) at Pericardium 6 (PC 6) and Stomach 36 (ST 36) suppressed the gag reflex, compared with a sham placebo. The subjects were 60 healthy adults randomly chosen to receive acupuncture, TEAS, or sham-TEAS on PC 6, located on the forearm, and ST 36, located on the lower leg. The gag reflex was measured by inserting a saliva ejector slowly down each participant's throat to determine the maximum tolerance of the gag reflex; the insertion length was used as an index of this reflex. Results: There was a significant difference in pre- and postintervention insertion lengths in all groups (paired t-test; all groups; P < 0.001). The differences in the insertion length among the groups (P = 0.76) and the interaction effect (group × time) were not significant (P = 0.79; 2-way analysis of variance). Conclusions: This study suggested that PC 6 and ST 36 stimulation was no different than placebo for alleviating the gag reflex.

Surgical Management of Jugular Foramen Schwannomas.

Simple SummaryTreatments of jugular foramen schwannomas may be challenging due to critical anatomical relations and the involvement of different aspects of the skull base. Advances in microsurgery have led to improved outcomes over recent decades, whereas in contrast, some advocate stereotactic radiotherapy as an effective therapy, controlling the tumor volume with few complications. In this manuscript, we present the outcomes and adverse events in a contemporary cohort and discuss surgical advantages and disadvantages of different performed classic skull base approaches.Background: Resection of jugular foramen schwannomas (JFSs) with minimal cranial nerve (CN) injury remains difficult. Reoperations in this vital region are associated with severe CN deficits. Methods: We performed a retrospective analysis at a tertiary neurosurgical center of patients who underwent surgery for JFSs between June 2007 and May 2020. We included nine patients (median age 60 years, 77.8% female, 22.2% male). Preoperative symptoms included hearing loss (66.6%), headache (44.4%), hoarseness (33.3%), dysphagia (44.4%), hypoglossal nerve palsy (22.2%), facial nerve palsy (33.3%), extinguished gag reflex (22.2%), and cerebellar dysfunction (44.4%). We observed Type A, B, C, and D tumors in 3, 1, 1, and 4 patients, respectively. A total of 77.8% (7/9) underwent a retrosigmoid approach, and 33.3% (3/9) underwent an extreme lateral infrajugular transcondylar (ELITE) approach. Gross total resection (GTR) was achieved in all cases. The rate of shunt-dependent hydrocephalus was 22.2% (2/9). No further complications requiring surgical intervention occurred during follow-up. The median follow-up time was 16.5 months (range 3–84 months). Conclusions: Considering the satisfying outcome, the GTR of JFSs is feasible in performing well-known skull base approaches. Additional invasive and complicated approaches were not needed. Radiosurgery may be an effective alternative for selected patients.

Infant aspiration and associated signs on clinical feeding evaluation

ObjectivesFew studies have examined clinical signs of aspiration in infants <51 weeks post-menstrual age (PMA) for whom the laryngeal cough reflex is not fully developed. This retrospective study explored 1) the association between signs of aspiration on a clinical feeding evaluation (CFE) and/or comorbid conditions with aspiration (silent or overt) on a modified barium swallow study (MBS) for infants in this age range, 2) the association between lower respiratory infection (LRI) and aspiration on MBS, and 3) the sensitivity and specificity of detecting aspiration according to signs on CFE and the evaluating speech-language pathologist's (SLP) years of experience. MethodsA retrospective review of charts of patients with MBS completed January 1, 2012–December 31, 2014 was performed. Patients were included if they were <51-weeks PMA at the time of MBS and had a CFE conducted no more than seven days prior to the MBS. Patient age, comorbidities, and MBS and CFE details were collected. The impact of CFE findings, patient age, comorbid syndromes/associations, and aerodigestive diagnoses on the odds of demonstrating silent aspiration (SA) or overt aspiration during MBS with thin liquids was determined using logistic regression, and the sensitivity and specificity of CFE for identifying SA was calculated. ResultsResults from 114 patients indicated that 46 (40 %) of the infants had SA and nine (8 %) had overt aspiration on MBS. Notable signs on CFEs were cough (36 %), oxygen desaturations (33 %), and chest congestion (32 %). On multiple regression analysis there was increased odds of SA on MBS with at least one clinical sign on CFE (OR: 24.3, p = 0.02), chronic lung disease, (OR: 18.2, p = 0.01), and airway abnormalities (OR: 2.94, p = 0.01). Cough on CFE was associated with increased odds of overt aspiration on MBS (OR: 5.69, p = 0.04). Neither SA nor overt aspiration were significantly associated with LRI. Sensitivity and specificity of CFE for correctly identifying the presence of SA were 98 % and 15 %, respectively; experience of the SLP was not a contributing factor. ConclusionFurther study is required to determine if specific signs on CFE are predictive of aspiration.

Aesthesiometer-Based Testing for Laryngopharyngeal Hyposensitivity.

To develop a method for threshold estimation of the laryngeal adductor reflex (LAR) response using Cheung-Bearelly monofilaments. Cross-sectional. Twenty-two healthy adults (12 men, 10 women) were tested for LAR response outcome using 30 mm 5-0 and 4-0 nylon monofilaments. Tactile stimuli were delivered to the aryepiglottic (AE) fold and medial pyriform sinus (MPS). Dichotomous classifier features and performance (area under the curve (AUC)), the LAR response outcome agreement and disagreement matrix, and test-retest reliability were examined. From those data, a test protocol that would minimize patient burden to estimate the LAR triggering threshold was formulated. Classifier performance of 5-0 monofilament stimulation of the AE fold (sensitivity=0.63, specificity=0.63, PPV=0.74, NPV=0.25) and MPS (sensitivity=0.45, specificity=0.77, PPV=0.74, NPV=0.23,) was slightly below that of 4-0 monofilament stimulation of the AE fold (sensitivity=0.82, specificity=0.50, PPV=0.82, NPV=0.50) and MPS (sensitivity =0.84, specificity=0.64, PPV=0.90, NPV=0.56), based on AUC. LAR response outcome agreement for 5-0 and 4-0 stimulations was high (93%) for 5-0 positive response, but low (29%) for 5-0 negative response. Aesthesiometer test-retest reliability for LAR response outcome was excellent (Cronbach's alpha=0.97). Threshold estimation of the LAR response may be operationalized by adopting a decision tree protocol. For negative LAR response to initial 5-0 monofilament stimulation and positive response to subsequent 4-0 monofilament stimulation, the higher threshold is confirmed. Positive LAR response to 5-0 or 4-0 monofilament stimulation is expected in over 90% of asymptomatic adults. Negative LAR response to 4-0 monofilament stimulation identifies patients at risk for laryngopharyngeal hyposensitivity. 3b Laryngoscope, 132:163-168, 2022.

Laryngeal Adductor Reflex Movement Latency Following Tactile Stimulation.

To measure the latency of laryngeal adductor reflex (LAR) motion onset at 2 laryngopharyngeal subsites using calibrated aesthesiometers. Cross-sectional. Academic institution. Twenty-one asymptomatic, healthy subjects (11 male, 10 female) underwent laryngopharyngeal sensory testing with tactile stimuli delivered to the aryepiglottic fold and medial pyriform sinus using 30-mm Cheung-Bearelly monofilaments (4-0 and 5-0 nylon sutures) via channeled flexible laryngoscope. The LAR onset latency, defined as the first visual detection of ipsilateral vocal fold adduction following tactile stimulation, was measured with frame-by-frame analysis of video recordings. The overall mean LAR latency across both subsites and stimulation forces was 176.6 (95% CI, 170.3-183.0) ms, without significant difference between subsites or forces. The critical value for LAR response latency prolongation at the .01 significance level was 244 ms. At 30 frames/s video capture resolution, LAR response latency ≥8 frame intervals would indicate abnormal prolongation. Aesthesiometer-triggered LAR latency appears to be invariant over an 8.7-dB force range and between the aryepiglottic fold and medial pyriform sinus subsites in controls. Laryngeal adductor reflex latency incongruences between stimulation forces or laryngopharyngeal subsites may serve as pathophysiological features to dissect mechanisms of upper aerodigestive tract disorders. Level 3B.

Suppressing Gag Reflex with Low-Level Laser Therapy on Acupoint PC6: A Case Report

Background: Gag reflex is a common problem in dental procedures such as pediatric patients, third molar extraction, periodontal surgery, taking radiography, oral examination, and alginate impression. Among different anti-gagging methods, laser acupuncture that use low-level laser therapy (LLLT) or photobiomodulation seems to be the newest and most practical method. Case report: Here, we report pericard 6 (PC6) point laser acupuncture as a practical chairside method to suppress gagging in our patient just before scaling and root planning (SRP). Results: Our case was a 33-year-old man who had sever gag reflex, and therefore, could not receive dental care in his whole life. His dentist scheduled to do scaling and surgically extract his third molar. We controlled the gag reflex successfully by stimulating PC6 point on his wrist with Diode LASER. SRP and extraction of third molar were done at the same session. Conclusion: LLLT acupuncture is a preferred method due to less chair time, low invasiveness, and high safety compared to other methods. The acupoint P6 seems to be more practical than other anti-gaging points in dentistry as it is accessible when patient is on dental unit.

Prevention of Hyperactive Gag Reflex during Dental Procedures in COVID-19 Pandemic

Prevention of Hyperactive Gag Reflex during Dental Procedures in COVID-19 Pandemic

Digital Workflow for Establishing the Posterior Palatal Seal on a Digital Complete Denture

The posterior palatal seal (PPS) plays important roles in improving denture retention, preventing food and debris from entering under the denture base, reducing the gag reflex, providing more strength across the denture, and making the distal border less noticeable to the tongue. Digital dentures have become popular, owing to the use of computer-aided design and computer-aided manufacturing and rapid prototyping technologies. However, limited research has been conducted on a digital workflow to establish the PPS. This article presents a technique to establish the PPS by using digital technologies for providing the advantages of the PPS to patients wearing digital dentures.

New style for nasopharyngeal swab with a mask: image-evaluation

COVID-19, caused by SARS-CoV-2, is rapidly spreading worldwide and has become a threat to humankind. Respiratory infectious viruses such as SARS-CoV-2 are transmitted via contact and droplets and have a high secondary attack rate ranging from 3.0%–11.2% in households (Wiersinga et al., 2020). Diagnosis of respiratory infectious virus is performed by collecting specimens from the surface of the respiratory mucosa using nasopharyngeal swabs (Föh et al., 2020; Marty et al., 2020). However, it is a high-risk procedure for healthcare workers because it causes pharyngeal reflexes or sneezing.

Dysphagia bedside evaluatation in adults with nasogastric tube

The theoretical analysis of scientific literature sources and practice show that standardized adult assessment tools for the evaluation of adult swallowing disorders and readiness for withdrawal of the nasogastric tube (NGZ) are not uniformly used in Lithuanian health care institutions. The theoretical analysis of the assessment of swallowing disorders in adults fed by NGZ in the article showed that in the early stage of the disorder, examinations that are performed in the patient's ward and do not require radiological evaluation are sufficiently accurate. The aim of the study is to reveal the tools and methodologies for the evaluation of swallowing disorders in adults fed by NGZ in the patient's ward during the acute period of the disease. After the theoretical analysis of scientific literature sources, it can be stated that: enteral feeding improves feeding quality, but it restricts patient's movements, complicates communication, induces isolation; accurate assessment of dysphagia can be made by performing a swallowing sample in the patient’s ward; assessment of swallowing function takes into account masticatory muscle function, movements of lips, tongue and soft palate, swallowing, cough and gag reflex, oral control, oral residue, voice quality after swallowing and aspiration risk.