Effectiveness of Outpatient Treatment in Ear, Nose, and Throat Clinics for Dysphagia and the Role of Questionnaires

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 8; p. e66369
• Main Authors: Yamano, Takafumi, Kimura, Shoichi, Wada, Kaori, Omori, Fumitaka, Nakamura, Ayumi, Fukuyo, Kazumasa
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 07.08.2024
• Subjects: Amyloidosis; Clinics; Dementia; Dysphagia; Endoscopy; Esophagus; Exercise; Food; Gastroesophageal reflux; Laryngeal cancer; Males; Meals; Otolaryngology; Pneumonia; Questionnaires; Radiation therapy; Rehabilitation; Speech therapists; Stroke; Swallowing; nose; questionnaire; swallowing; fiberoptic endoscopic evaluation of swallowing; ear; dysphagia; and throat clinics
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.66369

Background While most research on dysphagia treatment has focused on inpatients, less attention has been given to outpatient settings, particularly in ear, nose, and throat (ENT) clinics. Additionally, while questionnaires are commonly used as screening tools in dysphagia management, their correlation with outcomes such as pneumonia incidence or sustained oral intake is rarely discussed. This study aimed to evaluate the effectiveness of outpatient treatment in ENT clinics for dysphagia, including improvement in subjective symptoms, and to assess the role of the questionnaire. Methodology In total, 59 patients (38 males and 21 females) aged 53-93 years (mean age = 79 years) attended the outpatient swallowing clinic. All participants retained sufficient ability in activities of daily living to independently visit the hospital and could orally ingest food, and none required tube feeding. Subjective symptoms were evaluated using the questionnaire. Swallowing assessments were conducted by an otolaryngologist and via swallowing endoscopy. A speech-language pathologist led the swallowing rehabilitation, which included encouraging family involvement and home practice. Results The most frequent issue reported was munching during meals. Of the 59 patients, 22 underwent continuous outpatient rehabilitation. Of these, 17 (77%) showed improvement; 11 had improvement in both subjective symptoms and fiberoptic endoscopic evaluation of swallowing (FEES) scores, five in subjective symptoms only, and one in FEES scores only. Five patients showed no change/worsening conditions. Conclusions The questionnaire proved useful as a screening tool but fell short in terms of prognosis estimation. The findings suggest that information from the questionnaire should be used to gauge treatment effectiveness, noting that some cases showed improvement in subjective symptoms alone.