Fiberoptic endoscopic evaluation of swallowing in amyotrophic lateral sclerosis: comparison with older people with dysphagia and relationship with time since diagnosis.
Ramon Cipriano Pacheco de Araújo, Cynthia Meira de Almeida Godoy, Lidiane Maria de Brito Macedo Ferreira and 2 others
PMID 41259564WHAT IT FOUND
In dysphagic patients, those with ALS had more thin-liquid leakage, residue, penetration and aspiration than older dysphagic adults without neurological disease.
Diagnosis for more than 3 years was linked to response starting in the pyriform sinuses, moderate residues and need for an alternative feeding route.
Key findings
01The ALS group showed more thin-liquid FEES abnormalities than the older dysphagic group, including posterior oral leakage, pharyngeal residues, laryngeal penetration and aspiration.
02The groups differed significantly in onset of pharyngeal response, severity of pharyngeal residues and level of oral intake.
03In the ALS group, those diagnosed for more than 3 years had onset in the pyriform sinuses, moderate residues and oral intake dependent on an alternative feeding route.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a retrospective, convenience sample from one hospital, so the findings may not apply to other populations. The raters were not blinded to diagnosis, which could affect subjective FEES ratings. The groups were not age-matched: the ALS group averaged 62.1 years and the older dysphagic group averaged 71.0 years. Only one 5-mL volume was tested for each liquid and one 8-g cracker was offered, which may not reflect usual eating. The study did not report symptom onset type, such as limb or bulbar onset, or medication use. The time-since-diagnosis analysis included only 14 ALS participants diagnosed for more than 3 years. The design cannot show that ALS or time since diagnosis caused the swallowing differences.
Declared interests
The only funding and conflict information supplied was financial support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil, CAPES, Funding Code 001.
The easy way to misread this
Do not use these FEES patterns to diagnose ALS or to claim that a treatment works. The study compared existing records, raters were not blinded, and it did not test interventions or diagnostic accuracy.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →