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Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia

Owing to rapid population aging, patients with dysphagia are significantly increasing in society. Dysphagia treatment is aimed at the restoration of the swallowing function and the prevention of recurrent aspiration-induced pulmonary infection. However, despite intensive rehabilitation, oral food in...

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Autores principales: Ito, Hiroaki, Nagao, Asuka, Maeda, Suguru, Nakahira, Maya, Hyodo, Masamitsu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488804/
https://www.ncbi.nlm.nih.gov/pubmed/37685624
http://dx.doi.org/10.3390/jcm12175555
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author Ito, Hiroaki
Nagao, Asuka
Maeda, Suguru
Nakahira, Maya
Hyodo, Masamitsu
author_facet Ito, Hiroaki
Nagao, Asuka
Maeda, Suguru
Nakahira, Maya
Hyodo, Masamitsu
author_sort Ito, Hiroaki
collection PubMed
description Owing to rapid population aging, patients with dysphagia are significantly increasing in society. Dysphagia treatment is aimed at the restoration of the swallowing function and the prevention of recurrent aspiration-induced pulmonary infection. However, despite intensive rehabilitation, oral food intake remains inadequate in many patients with severe dysphagia, which results in the deterioration of patients’ quality of life and joy of living. Surgical intervention may serve as a useful therapeutic strategy to restore swallowing function in these patients. The study included 25 patients (mean, 70.4 years; male/female ratio, 20:5) with chronic dysphagia. Dysphagia was associated with cerebrovascular diseases in sixteen patients; with age-induced physiological deterioration in five patients; and with miscellaneous etiologies in four cases. Cricopharyngeal and infrahyoid myotomies were performed in all patients. Laryngeal elevation and the medialization of the paralyzed vocal fold were performed in 15 and 3 patients, respectively. The Food Intake Level Scale (FILS) and videoendoscopic examination score (VEES) were used to evaluate swallowing function. The FILS showed a restoration of oral food intake alone in 72% of patients, and 64% of patients maintained this improvement at their last follow-up visit. We observed significantly improved VEES scores postoperatively. However, patients with cognitive impairment or advanced age showed poor outcomes. In conclusion, surgical intervention may be an effective therapeutic option to restore swallowing function in cases of sustained severe dysphagia; however, surgical indications require careful consideration.
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spelling pubmed-104888042023-09-09 Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia Ito, Hiroaki Nagao, Asuka Maeda, Suguru Nakahira, Maya Hyodo, Masamitsu J Clin Med Article Owing to rapid population aging, patients with dysphagia are significantly increasing in society. Dysphagia treatment is aimed at the restoration of the swallowing function and the prevention of recurrent aspiration-induced pulmonary infection. However, despite intensive rehabilitation, oral food intake remains inadequate in many patients with severe dysphagia, which results in the deterioration of patients’ quality of life and joy of living. Surgical intervention may serve as a useful therapeutic strategy to restore swallowing function in these patients. The study included 25 patients (mean, 70.4 years; male/female ratio, 20:5) with chronic dysphagia. Dysphagia was associated with cerebrovascular diseases in sixteen patients; with age-induced physiological deterioration in five patients; and with miscellaneous etiologies in four cases. Cricopharyngeal and infrahyoid myotomies were performed in all patients. Laryngeal elevation and the medialization of the paralyzed vocal fold were performed in 15 and 3 patients, respectively. The Food Intake Level Scale (FILS) and videoendoscopic examination score (VEES) were used to evaluate swallowing function. The FILS showed a restoration of oral food intake alone in 72% of patients, and 64% of patients maintained this improvement at their last follow-up visit. We observed significantly improved VEES scores postoperatively. However, patients with cognitive impairment or advanced age showed poor outcomes. In conclusion, surgical intervention may be an effective therapeutic option to restore swallowing function in cases of sustained severe dysphagia; however, surgical indications require careful consideration. MDPI 2023-08-26 /pmc/articles/PMC10488804/ /pubmed/37685624 http://dx.doi.org/10.3390/jcm12175555 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ito, Hiroaki
Nagao, Asuka
Maeda, Suguru
Nakahira, Maya
Hyodo, Masamitsu
Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia
title Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia
title_full Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia
title_fullStr Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia
title_full_unstemmed Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia
title_short Clinical Significance of Surgical Intervention to Restore Swallowing Function for Sustained Severe Dysphagia
title_sort clinical significance of surgical intervention to restore swallowing function for sustained severe dysphagia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488804/
https://www.ncbi.nlm.nih.gov/pubmed/37685624
http://dx.doi.org/10.3390/jcm12175555
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