Clinical Swallow Examination Following Laryngectomy: An International e-Delphi Consensus Process.
Sarah E Wilson, Bena Brown, Clare L Burns
PMID 39838111WHAT IT FOUND
International speech pathologists agreed on 34 items for examining swallowing after laryngectomy.
The framework drops standard checks like voice quality and aspiration, focusing instead on effort, backflow, and the patient's history to match this population's unique anatomy.
Key findings
01The consensus framework includes 34 items, with more than two thirds related to information gathering rather than direct observation.
02Standard clinical swallow examination components like voice quality and cough strength are excluded because aspiration cannot occur after laryngectomy.
03Assessment of the hypoglossal nerve was the only oromotor component included in the final consensus.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The participant panel did not represent all countries, ethnicities, or healthcare contexts, so the framework may need adjustment for local practices. Attrition occurred between rounds, with only 20 participants completing the final round out of the initial 34. The study established consensus on what to assess, but did not test whether this framework improves patient outcomes or diagnostic accuracy. The exclusion criteria were modified during the study because too few items were initially excluded, which may have influenced the final list.
Declared interests
The study was funded by The University of Queensland. The authors declared no conflicts of interest.
The easy way to misread this
Do not treat this consensus list as a validated diagnostic tool. It represents expert agreement on what to ask and observe, not evidence that these items accurately diagnose swallowing disorders or improve patient outcomes.