Pharyngeal phase of swallowing in post-stroke dysphagia: videoendoscopy and speech-language-hearing assessment.
Ramon Cipriano Pacheco de Araújo, Lidiane Maria de Brito Macedo Ferreira, Cynthia Meira de Almeida Godoy and 1 others
PMID 39166600WHAT IT FOUND
Chronic stroke patients with swallowing complaints showed more tongue weakness, food left in the throat after swallowing, and food entering below the vocal folds than dysphagia patients without stroke, including with thickened liquids and solid food.
Key findings
01In the stroke group, 19 people had reduced tongue strength, and 21 had abnormal tongue mobility; in the no-stroke group, 11 had reduced tongue strength and 19 had abnormal mobility.
02Food passed below the vocal folds during FEES in 11 of 44 stroke participants with thin liquid, 6 of 44 with mildly thick liquid, 7 of 44 with extremely thick liquid, and 4 of 44 with regular solid food; in the no-stroke group this happened in 3 of 90 with thin liquid and in none with the other consistencies.
03Pharyngeal residue after swallowing was reported in the stroke group for thin liquid in 18 of 44, mildly thick liquid in 21 of 44, extremely thick liquid in 23 of 44, and regular solid food in 17 of 44, versus 11 of 90, 11 of 90, 9 of 90, and 8 of 90 in the no-stroke group.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The design was retrospective and cross-sectional, so it cannot establish cause and effect. The sample was a convenience sample from one clinic, and the groups were not matched: the stroke group was predominantly male and the non-stroke group predominantly female. All stroke participants had chronic ischemic stroke, so the findings may not apply to acute stroke or hemorrhagic stroke. Some assessment measures were subjective, including tongue strength judged against the evaluator's gloved finger. Dysphagia screening was not standardized, and the non-stroke group had idiopathic causes without detailed characterization. The study did not report lesion location or stroke severity, which the authors noted can influence swallowing findings.
The easy way to misread this
Do not read the aspiration findings as proof that stroke caused these swallowing problems. This was a retrospective cross-sectional record review, and it cannot establish cause and effect.