Longitudinal Analysis of Dysphagia and Factors Related to Postoperative Pneumonia in Patients Undergoing Esophagectomy for Esophageal Cancer.
Asako Kaneoka, Haruhi Inokuchi, Rumi Ueha and 5 others
PMID 37934250WHAT IT FOUND
After esophagectomy, pharyngeal residue and vocal fold immobility worsened, with residue linked to pneumonia.
Hyoid movement and vocal fold issues persisted at three months, though all patients returned to a full diet and no aspiration occurred.
Key findings
01Increased pharyngeal residue two weeks after surgery was associated with postoperative aspiration pneumonia.
02Hyoid displacement and vocal fold immobility significantly worsened after surgery and did not fully recover by three months.
03All participants returned to a full oral diet three months after surgery, and no aspiration events occurred at that time.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Small sample size (n=29) from a single center limits generalizability. Analysis was restricted to 5 mL thickened liquid; thin liquid trials were discontinued for safety, potentially missing more severe aspiration events. Only one speech-language pathologist scored the MBSImP, introducing potential observer bias. Patients who could not complete VFSS at all three time points were excluded, possibly omitting those with the most severe dysphagia. The study did not analyze the specific location of pharyngeal residue.
Declared interests
Funded by the Japan Society for the Promotion of Science, the Japanese Association of Rehabilitation Medicine, and The University of Tokyo. No conflicts of interest declared.
The easy way to misread this
Do not assume that the return to a full oral diet at three months indicates a complete recovery of swallowing physiology. Hyoid displacement and vocal fold mobility remained impaired, and the lack of aspiration in this small group does not guarantee safety for all patients or with larger boluses.