Introduction: Early identification of patients at risk of dysphagia is of paramount importance. To date, no dysphagia screening questionnaire has been validated and translated into Polish that can be widely used in a multidisciplinary setting. Our study aimed to validate and adapt the Polish version of the Eating Assessment Tool-10 questionnaire (EAT-10). Materials and Methods: The EAT-10 questionnaire was translated into Polish using a formal forward–backward translation method. The Polish EAT-10 was administered to 109 patients with different dysphagia etiologies and 24 control subjects. Internal consistency, unidimensionality, test–retest reliability and external validity against the Visual Analog Scale (VAS), and Flexible Endoscopic Evaluation of Swallowing (FEES) were performed. Results: The EAT-10PL demonstrated excellent internal consistency (Cronbach’s α = 0.958) and confirmed unidimensionality. We found a strong correlation between EAT-10PL with the Visual Analog Scale (VAS) (rs = 0.94, p < 0.001) and a weaker correlation with the PAS (rs = 0.55, p < 0.001). We reported a sensitivity of 79.5% and specificity at the level of 60.0%, using ≥3 as a cut-off point. The statistically chosen cutoff point for PAS ≥ 2 and EAT-10 ≥ 6 indicated optimal specificity (70.0%) and sensitivity (79.5%) of measurements performed using EAT-10PL. The EAT-10PL questionnaire demonstrates high discriminatory ability relative to the control group (F(4, 104) = 16.219, p < 0.001, η2 = 0.38 [95%CI: 0.22–0.48]). Conclusions: The Polish EAT-10 is a valid and reliable, self-administered questionnaire for dysphagic patient identification. The Polish EAT-10 ≥ 3 can be considered abnormal; however, it seems that EAT-10PL is not appropriate for patients with dysphagia and a chronic cough background, and further research is required.
(1) Background: Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is one of the two gold-standard tools for assessing oropharyngeal dysphagia (alongside Videofluoroscopic Swallowing Study). Although generally considered safe, concerns about complications persist, particularly in systems where FEES is not routine and professional roles differ. The aim of this study was to evaluate the safety of FEES performed by both speech-language pathologists (SLPs) and physicians, in order to provide evidence of its safety in a healthcare system where the procedure is not yet widely established and to identify patient subgroups potentially at higher risk of procedure-related complications. (2) Methods: This retrospective study analyzed 964 consecutive FEES procedures. Examinations were carried out by trained SLPs or physicians. Data included demographics, clinical status, operator qualifications, setting, and complications, classified as minor (vomiting, poor tolerance, early termination) or major (laryngospasm, epistaxis). (3) Results: The overall complication rate was 1.14% (11/964): 0.6% minor and 0.5% major. All events were self-limiting. Complication rates did not differ between SLPs (1.05%) and physicians (1.23%) or by experience, setting, drug use, penetration–aspiration scale score, or nasogastric tube. Four complications occurred in amyotrophic lateral sclerosis patients, suggesting higher risk. (4) Conclusions: FEES is safe and well tolerated when performed by either physicians or SLPs. These findings underscore the value of task sharing in dysphagia diagnostics, demonstrating that a shared model increases service capacity, reduces delays, and facilitates timely management of dysphagia.
Celem pracy była ocena funkcjonowania chorych z zaburzeniami połykania po operacji radykalnego usunięcia krtani. Do badania wstępnie zakwalifikowano 20 pacjentów, będących dłużej niż 6 miesięcy po całkowitym usunięciu krtani, wymagających przeprowadzenia badania wideofluoroskopowego (VFSS) ze względu na zgłaszane zaburzenia połykania. Grupę ostateczną stanowiło 10 osób (8 mężczyzn i 2 kobiety). Procedura badania obejmowała: zebranie wywiadu, wykonania pełnego badania VFSS oraz wypełnienie przez pacjenta kwestionariusza MDADI. Najczęściej stwierdzanymi problemami były: brak kontaktu nasady języka z tylną ścianą gardła, zaburzenia obróbki oralnej kęsa oraz ruchy pompujące języka. Chorzy oceniali nisko swoją jakość życia. Obecność lub brak regurgitacji treści pokarmowych do nosa znacznie wpływał na funkcjonowanie pacjentów. Zgłaszanie przez chorych zaburzeń połykania oraz problemów z wytworzeniem głosu i mowy zastępczej jest wskazaniem do dalszej diagnostyki (np. VFSS). Dobór skutecznej metody terapeutycznej może wpłynąć na poprawę jakości życia tych osób.
Background: The aim of the study was to determine the prevalence of dysphagia in patients with chronic cough and its relationship with the long-term persistence of these symptoms. Methods: Thirty consecutive patients. All patients underwent physical examination, ENT assessment, videolaryngoscopy, functional phoniatric assessment at rest and speech, Water-Swallow Test, and Fiberoptic Endoscopic Evaluation of Swallowing disorders with Reflux Finding Score. Reflux Symptom Index questionnaire was performed. The study was approved by the local Ethics Committee Review Board (KB/39/A/2016). Results: The results of the RFS and the RSI questionnaire showed the risk of reflux in participating patients. The patients presented episodes of spillage, double swallows, penetration, aspiration and residue of food at the hypopharynx. The results of functional assessment correlated with the Water-Swallow Test. The correlation between Fiberoptic Endoscopic Evaluation of Swallowing disorders and Water-Swallow Test results was found for aspiration risk, spillage, and retention of saliva. Conclusion: The results of the study showed prevalence of dysphagia in most patients with chronic chough. It seems that phoniatric assessment in those cases should be expanded and the following tests should be performed: assessment of the laryngeal elevation, Water-Swallow Test, and Fiberoptic Endoscopic Evaluation of Swallowing disorders.
30 December 2017 in Polski Przegląd Otorynolaryngologiczny