Swallowing Characteristics in Patients with Multiple System Atrophy Analyzed Using FEES Examination.
Francesco Mozzanica, Nicole Pizzorni, Angelo Eplite and 6 others
PMID 37733099WHAT IT FOUND
In MSA patients on full oral diets, nasal camera swallowing tests showed thin liquids were least safe: 17 of 24 had material enter above the vocal folds and 5 went below the vocal folds.
Residue was common, and group comparisons were mostly not different.
Key findings
01With thin liquid, 17 of 24 tested patients had penetration and 5 had aspiration; no aspiration was documented with semisolid or solid.
02Delayed pharyngeal phase was the most common dysphagia phenotype at 92%, followed by posterior oral incontinence with liquids at 52% and propulsion deficit with semisolids and solids at 44%.
03The MSA-P and MSA-C groups did not differ significantly in dysphagia phenotypes, unsafe-swallow distribution, or laryngeal movement alterations.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included only 25 patients, and the authors said the small number makes comparisons between MSA-P and MSA-C need extreme caution. All patients were on a full oral diet, so the results may not apply to MSA patients who need tube feeding or have more restricted oral intake. Some texture trials were skipped because of choking risk, so liquid and semisolid counts used 24 patients and solid counts used 19 patients. The dysphagia phenotype classification was judged as present or absent, and the authors said its psychometric properties still need analysis. No treatment was tested, so the paper cannot show whether therapy, diet changes, or other interventions improve swallowing safety or efficiency.
Declared interests
Funding was provided by Università degli Studi di Milano. The supplied text gives no company funding or author conflict list.
The easy way to misread this
Do not treat these FEES findings as proof that a swallowing therapy works. The paper did not test treatment; it described what 25 patients showed on assessment.