Wang Brandon J, Carter Felicia L, Altman Kenneth W
Ear Nose Throat J. 2020 Oct 12:145561320951647. doi: 10.1177/0145561320951647.
There is a high prevalence of dysphagia in patients with neuromuscular diseases and stroke, and consequences can be profound. However, the correlation of dysarthria and oral-oropharyngeal dysphagia remains unclear. This review aimed to define the clinical co-presentation of dysarthria and dysphagia in this population. A PubMed search to identify literature on the prevalence of dysarthria and dysphagia was systematically conducted in the English language literature since 1995. Subjective and objective outcomes instruments were identified for both dysarthria and dysphagia. Studies that included prevalence and co-presentation were included. Inclusion and exclusion criteria were applied according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Of the 1,056 articles identified in the search, 20 articles met the search criteria. An additional 4 articles were examined for a total of 24 articles for analysis. Dysarthria and dysphagia were found to be highly prevalent among patients with neuromuscular disease (NMD). Overall, there was a higher prevalence of dysarthria than dysphagia. Of those patients with dysphagia, some reports estimate 76-90% of patients with NMD also had dysarthria. Dysarthria is a strong clinical clue to the presence of dysphagia. Existing subjective questionnaires may not reveal the presence of oropharyngeal dysphagia, but objective measures are more revealing. Further study to correlate the degree of dysarthria and severity of oral-oropharyngeal dysphagia are warranted.
神经肌肉疾病和中风患者中吞咽困难的患病率很高,其后果可能很严重。然而,构音障碍与口腔-口咽吞咽困难之间的相关性仍不清楚。本综述旨在明确该人群中构音障碍和吞咽困难的临床共同表现。自1995年以来,我们在英文文献中系统地进行了PubMed检索,以查找关于构音障碍和吞咽困难患病率的文献。确定了构音障碍和吞咽困难的主观和客观结局指标。纳入了包括患病率和共同表现的研究。根据系统评价和Meta分析的首选报告项目(PRISMA)应用纳入和排除标准。在检索到的1056篇文章中,20篇文章符合检索标准。另外检查了4篇文章,共24篇文章进行分析。发现构音障碍和吞咽困难在神经肌肉疾病(NMD)患者中非常普遍。总体而言,构音障碍的患病率高于吞咽困难。在那些吞咽困难的患者中,一些报告估计76-90%的NMD患者也有构音障碍。构音障碍是存在吞咽困难的一个有力临床线索。现有的主观问卷可能无法揭示口咽吞咽困难的存在,但客观测量更具揭示性。有必要进一步研究构音障碍程度与口腔-口咽吞咽困难严重程度之间的相关性。