School of Orthodontics Brooks Rehabilitation College of Healthcare Sciences, Jacksonville University, Jacksonville, FL.
Private Practice, Izmir, TURKEY.
J Craniofac Surg. 2023 Sep 1;34(6):e576-e580. doi: 10.1097/SCS.0000000000009405. Epub 2023 Jun 7.
To determine the occurrence of oropharyngeal dysphagia (OD) signs and symptoms in patients with operated unilateral cleft lip and palate (CLP).
This prospective study was conducted on 15 adolescents with operated unilateral CLP (CLP group) and 15 non-cleft volunteers (control group). Initially, the Eating Assessment Tool-10 (EAT-10) questionnaire was administered to subjects. OD signs and symptoms such as coughing, the sensation of choking, globus sensation, the need to clear the throat, nasal regurgitation, difficulties of bolus control multiple swallowing were evaluated by patient complaints and physical examination of swallowing function. Also, the Functional Outcome Swallowing Scale was used to determine the severity of the OD. Fiberoptic endoscopic evaluation of swallowing (FEES) with water, yogurt, and crackers was performed.
The prevalence of OD signs and symptoms based on patient complaints and physical examination of swallowing was low (range, 6.7 to 26.7%), and nonsignificant differences were observed between the groups for these parameters as well as for EAT-10 scores. According to the Functional Outcome Swallowing Scale findings, 11 of 15 patients with CLP were asymptomatic. Fiberoptic endoscopic evaluation of swallowing indicated that post-swallow pharyngeal wall residues with yogurt were significant in the CLP group with a prevalence of 53% ( P < 0.05), whereas differences between the groups in terms of cracker and water residues were nonsignificant ( P > 0.05).
OD in patients with repaired CLP was manifested mainly in the form of pharyngeal residue. However, it did not appear to cause significant increases in patient complaints compared with healthy individuals.
确定单侧唇裂腭裂（CLP）术后患者是否存在口咽吞咽困难（OD）的征象和症状。
本前瞻性研究纳入了 15 例接受单侧 CLP 手术的青少年患者（CLP 组）和 15 名非腭裂志愿者（对照组）。首先，对受试者进行饮食评估工具-10 （EAT-10）问卷评估。通过患者自述和吞咽功能体格检查，评估 OD 征象和症状，如咳嗽、哽噎感、球塞感、需要清嗓子、鼻反流、食团控制困难、多次吞咽等。此外，还使用功能性吞咽结局量表来确定 OD 的严重程度。对所有患者进行纤维内镜吞咽评估（FEES），使用水、酸奶和薄脆饼干进行检查。
基于患者自述和吞咽功能体格检查，OD 征象和症状的发生率较低（范围 6.7%至 26.7%），两组之间这些参数以及 EAT-10 评分均无显著差异。根据功能性吞咽结局量表的结果，15 例 CLP 患者中有 11 例无症状。纤维内镜吞咽评估显示，CLP 组患者在吞咽酸奶后，咽壁有残留，其发生率为 53%（P<0.05），而两组在饼干和水的残留方面无显著差异（P>0.05）。
修复后的 CLP 患者的 OD 主要表现为咽后残留物，但与健康个体相比，似乎不会引起患者自述的显著增加。
