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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...

All videoswallows are not performed equally…

Videofluoroscopy is one of the main instrumental tools used to assess swallowing biomechanics and physiology. In the UK, it is mainly within the remit of speech and language therapists (SLT) to perform videoswallows but there is considerable variability in both...

How well do different assessments of swallowing correlate with one another?

Swallowing (dys)function may be assessed by three key measures: 1. instrumental swallowing techniques such as the modified barium swallow (MBS) or videofluoroscopy; 2. functional measures of diet texture that patients can eat comfortably (usually rated by the clinician); and 3....

Analysing videofluroscopy: does it matter how it’s done?

Videofluoroscopy, as a tool that assesses the process of swallowing, has transformed our understanding of dysphagia. Clinicians can observe the biomechanics of a bolus moving from the oral cavity through the pharynx and oesophagus and into the stomach. Over the...

Measuring radiation fibrosis in patients with head and neck cancer

People treated with radiotherapy for head and neck cancer experience several acute and chronic effects of this treatment, of which fibrosis is perhaps the most common. Fibrosis occurs as a wound healing response and leads to scarring and reduced range...

The use of 3D videos to improve patient engagement with compensatory swallowing strategies

Patients with dysphagia are often asked to use compensatory techniques or manoeuvres to facilitate safe swallowing. For example, they may be taught to do a supraglottic swallow to minimise aspiration or a specific postural adjustment to support bolus flow. These...

Swallow toxicity score (DIGEST) and its clinical utility in oncology practice

The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST, graded from 0–4) was developed as a tool for clinicians to grade dysphagia from modified barium swallow studies (MBSS). The purpose is to provide a common terminology for adverse events of pharyngeal...

Is there increased cardiovascular risk with macrolide antibiotics?

This month’s Ed’s Choice delightfully reviews the potential cardiovascular consequences of long-term macrolide use in the treatment of chronic rhinosinusitis. This used to be one of my ‘go-to’ topics of conversation at home after a bad day at work, although...

Some guidelines for treating rhinological patients during the COVID-19 pandemic

This is a very interesting and informative multinational European guide to the treatment of rhinology patients during the current pandemic, describing the safe delivery of a rhinological service to patients. Much of this has become well understood and standard practice...