Clinical evolution of patients with neurogenic oropharyngeal dysphagia

Abstract

Introduction: oropharyngeal dysphagia is an alteration of the swallowing process that affects the passage of food or liquids from the oral cavity, pharynx and esophagus to the stomach, causing serious complications such as malnutrition, dehydration and aspiration pneumonia. It may arise from neuromuscular or neurological pathologies. Objective: to assess the clinical evolution of patients with oropharyngeal dysphagia of neurological and neuromuscular origin, considering their deterioration, stability, or improvement during a six-month follow-up period. Design: a retrospective observational study with analytical intent, derived from the population of another study of patients with neurogenic oropharyngeal dysphagia, evaluated over six months with three follow-ups: baseline, at the third month, and at the sixth month. Materials and methods: study variables included the evolution of cranial nerves signs and symptoms (hypoglossal, trigeminal and facial) and the individual score of the Eating Assessment Tool-10. Results: the absence of complete swallowing therapy at the sixth month was a risk factor for the clinical deterioration of neurogenic oropharyngeal dysphagia according to the Eating Assessment Tool-10 score (Hazard ratio 5.1 and confidence interval 1.5-17.3). Conclusions: complete and uninterrupted swallowing therapy should be considered for all patients with neurogenic oropharyngeal dysphagia. The role of the hypoglossal nerve as a tool for clinical monitoring should not be underestimated, nor should the importance of a thorough medical history in order to identify impactful comorbidities. Every self-assessment of symptoms in these patients should include the administration of the Eating Assessment Tool-10.