Laryngopharyngeal abnormalities in hospitalized patients with dysphagia

Gregory N Postma, W. Frederick McGuirt, Susan G. Butler, Catherine J. Rees, Heather L. Crandall, Kristina Tansavatdi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVES: To determine the prevalence of laryngopharyngeal (LP) abnormalities in hospitalized patients with dysphagia referred for flexible endoscopic evaluation of swallowing (FEES). STUDY DESIGN: Retrospective, blinded review by two otolaryngologists of 100 consecutive FEES studies performed and video-recorded by a speech-language pathologist (SLP). METHODS: Two otolaryngologists reviewed videos of 100 consecutive FEES studies on hospitalized patients with dysphagia for the presence of abnormal LP findings. RESULTS: Sixty-one male and 38 female patients comprised the hospital dysphagia cohort. The mean age was 62. One subject could not be evaluated because of the severity of the retained secretions, leaving 99 subjects in the cohort. Seventy-six percent had been previously intubated, with a mean intubation duration of 13 days. The overall prevalence of abnormal LP findings was 79%. Forty-five percent of the patients presented with two or more findings, which included arytenoid edema (33%), granuloma (31%), vocal fold paresis (24%), mucosal lesions (17%), vocal fold bowing (14%), diffuse edema (11%), airway stenosis (3%), and ulcer (6%). There was a significant difference in LP findings between those individuals who had or had not been intubated. CONCLUSIONS: Hospitalized patients with dysphagia are at high risk for LP abnormalities, particularly if they have been intubated, and may benefit from either 1) an initial joint examination by the SLP and otolaryngologist or 2) an otolaryngologist's review of the recorded examination conducted by the SLP. Such otolaryngology involvement could identify airway stenosis patients at an earlier stage, initiate granuloma treatment sooner, enable earlier biopsy of unexpected lesions, and allow follow-up of mucosal and neuromuscular findings that do not respond to medical management.

Original languageEnglish (US)
Pages (from-to)1720-1722
Number of pages3
JournalLaryngoscope
Volume117
Issue number10
DOIs
StatePublished - Oct 1 2007

Fingerprint

Deglutition Disorders
Deglutition
Language
Vocal Cords
Granuloma
Edema
Pathologic Constriction
Otolaryngology
Paresis
Intubation
Ulcer
Joints
Biopsy
Otolaryngologists
Pathologists

Keywords

  • Dysphagia
  • Flexible endoscopic evaluation of swallowing
  • Larynx
  • Pharynx

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Postma, G. N., McGuirt, W. F., Butler, S. G., Rees, C. J., Crandall, H. L., & Tansavatdi, K. (2007). Laryngopharyngeal abnormalities in hospitalized patients with dysphagia. Laryngoscope, 117(10), 1720-1722. https://doi.org/10.1097/MLG.0b013e31811ff906

Laryngopharyngeal abnormalities in hospitalized patients with dysphagia. / Postma, Gregory N; McGuirt, W. Frederick; Butler, Susan G.; Rees, Catherine J.; Crandall, Heather L.; Tansavatdi, Kristina.

In: Laryngoscope, Vol. 117, No. 10, 01.10.2007, p. 1720-1722.

Research output: Contribution to journalArticle

Postma, GN, McGuirt, WF, Butler, SG, Rees, CJ, Crandall, HL & Tansavatdi, K 2007, 'Laryngopharyngeal abnormalities in hospitalized patients with dysphagia', Laryngoscope, vol. 117, no. 10, pp. 1720-1722. https://doi.org/10.1097/MLG.0b013e31811ff906
Postma GN, McGuirt WF, Butler SG, Rees CJ, Crandall HL, Tansavatdi K. Laryngopharyngeal abnormalities in hospitalized patients with dysphagia. Laryngoscope. 2007 Oct 1;117(10):1720-1722. https://doi.org/10.1097/MLG.0b013e31811ff906
Postma, Gregory N ; McGuirt, W. Frederick ; Butler, Susan G. ; Rees, Catherine J. ; Crandall, Heather L. ; Tansavatdi, Kristina. / Laryngopharyngeal abnormalities in hospitalized patients with dysphagia. In: Laryngoscope. 2007 ; Vol. 117, No. 10. pp. 1720-1722.
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abstract = "OBJECTIVES: To determine the prevalence of laryngopharyngeal (LP) abnormalities in hospitalized patients with dysphagia referred for flexible endoscopic evaluation of swallowing (FEES). STUDY DESIGN: Retrospective, blinded review by two otolaryngologists of 100 consecutive FEES studies performed and video-recorded by a speech-language pathologist (SLP). METHODS: Two otolaryngologists reviewed videos of 100 consecutive FEES studies on hospitalized patients with dysphagia for the presence of abnormal LP findings. RESULTS: Sixty-one male and 38 female patients comprised the hospital dysphagia cohort. The mean age was 62. One subject could not be evaluated because of the severity of the retained secretions, leaving 99 subjects in the cohort. Seventy-six percent had been previously intubated, with a mean intubation duration of 13 days. The overall prevalence of abnormal LP findings was 79{\%}. Forty-five percent of the patients presented with two or more findings, which included arytenoid edema (33{\%}), granuloma (31{\%}), vocal fold paresis (24{\%}), mucosal lesions (17{\%}), vocal fold bowing (14{\%}), diffuse edema (11{\%}), airway stenosis (3{\%}), and ulcer (6{\%}). There was a significant difference in LP findings between those individuals who had or had not been intubated. CONCLUSIONS: Hospitalized patients with dysphagia are at high risk for LP abnormalities, particularly if they have been intubated, and may benefit from either 1) an initial joint examination by the SLP and otolaryngologist or 2) an otolaryngologist's review of the recorded examination conducted by the SLP. Such otolaryngology involvement could identify airway stenosis patients at an earlier stage, initiate granuloma treatment sooner, enable earlier biopsy of unexpected lesions, and allow follow-up of mucosal and neuromuscular findings that do not respond to medical management.",
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