Telepractice for the delivery of paediatric feeding services

During the current COVID-19 pandemic, telepractice is being heralded as the safest service delivery mode for the majority of outpatient consultations. Patients are reviewed by their healthcare specialist through video consultations, thus avoiding the need for patients to leave their...

Early injection laryngoplasty for iatrogenic vocal fold movement impairment – a safe and effective treatment

This Ed’s Choice examines the role of early injection laryngoplasty on swallowing dysfunction and is one of a few studies available in the literature. Research on early injection laryngoplasty has been predominately focused on voice and reducing the risk of...

Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?

Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...

Modified barium swallow studies: what is the radiation risk?

A modified barium swallow study (MBSS), also called a videofluoroscopy swallowing study uses ionising radiation to assist the clinician in visualising swallowing biomechanics from the oral cavity to the oesophagus. This procedure is currently one of the best methods used...

Sarcopenia and dysphagia in older community-dwelling adults

The prevalence of dysphagia in community-dwelling older adults is reported to be around 15%. Outside of common neurological causes such as stroke, Parkinson’s disease and dementia, recent studies have suggested that sarcopenia may be an independent risk factor for the...

Gastro-oesophageal reflux and cricopharyngeal dysfunction – how do they link?

It has been hypothesised that cricopharyngeal muscle hypertrophy develops as a response to chronic gastro-oesophageal reflux disease. The cricopharyngeus muscle is an important component and contributor to the upper oesophageal sphincter that creates a barrier between the pharynx and oesophagus....

Standardising videofluoroscopy assessment for bottle-fed babies

Swallowing problems in babies may occur for many reasons including complex medical problems, premature birth, and low birth-weight. Dysphagia causes several further morbidities such as poor nutrition and compromised respiration, often raising distress for both infants and their caregivers. Early...

From a dysphagia clinical trial to a multidisciplinary head and neck clinical pathway – the road to implementation

This paper describes the barriers and facilitators to establishing a structured and coordinated multidisciplinary care pathway for patients with head and neck cancer at a medical centre in the USA. The initiative was set in motion by the roll out...

Do nasogastric tubes affect aspiration risk?

A nasogastric tube (NGT) is frequently used for patients who are at risk of endotracheal aspiration of oral diet. However, this cannot eliminate the aspiration of saliva. The incidence of aspiration pneumonia in patients with NGT therefore remains high. Some...

Bothersome ‘burping’ – speech therapy may help

Most people experience belching as a normal phenomenon, often after eating or drinking carbonated drinks in particular. However, separate to this normal physiological phenomenon, some people experience belches that can occur much more frequently (up to 20 times a minute)...

Who finds it hard to swallow?

Early identification of dysphagia in inpatients on acute stroke wards has been recommended as best practice guidelines in many countries. However, several institutions fail to use formal dysphagia screening protocols and rely on informal detection by nurses and doctors. This...

Grading dysphagia as a toxicity in treating head and neck cancer

Common Terminology Criteria for Adverse Events (CTCAE) is a system used by clinicians to grade the toxicity of oncology treatments in a standardised manner. Dysphagia is perhaps the most common long-term toxicity of head and neck cancer treatment. Currently, a...