Kuuskoski Jonna, Rekola Jami, Sintonen Harri, Aaltonen Leena-Maija, Järvenpää Pia
Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, P.O. Box 52, Turku, 20521, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
Dysphagia. 2025 Sep 12. doi: 10.1007/s00455-025-10869-5.
Dysphagia is a common concern. In an outpatient phoniatric and otorhinolaryngology clinic, approximately one fourth of dysphagia patients are classified as having non-organic, or functional dysphagia. This study aimed to evaluate symptom severity, health-related quality of life (HRQoL) and disability among dysphagia patients. Additionally, it focused on assessing the impact of flexible endoscopic evaluation of swallowing (FEES) and swallowing guidance particularly for patients with functional dysphagia. We recruited 60 consecutive dysphagia patients from our phoniatrics clinic. They completed the Eating Assessment Tool (EAT-10), the 15D Health-related Quality of Life Instrument and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaires before their appointments. We performed FEES and gave swallowing guidance. One month later, the patients repeated the EAT-10, 15D, and WHODAS 2.0. At one-month follow-up, the EAT-10 scores of all 60 dysphagia patients (median age 65, range 18-89 years, 70% female), and the functional dysphagia patients (n = 15, 25%) had decreased significantly (p = 0.020, p = 0.029, respectively). Although the changes in the 15D and WHODAS 2.0 scores were insignificant, the score of WHODAS 2.0 item D3.3 concerning eating had decreased significantly in the functional dysphagia group (p = 0.020). Comparison of the whole dysphagia patient cohort to an age- and gender-standardized sample of the general population revealed significant differences in 15D total scores (p < 0.001) and 12 of the 15 dimensions. Dysphagia seems to significantly diminish patients' HRQoL in comparison to that of the general population. A short FEES intervention with swallowing guidance may alleviate symptoms, especially in functional dysphagia.
吞咽困难是一个常见问题。在门诊嗓音与耳鼻喉科诊所，约四分之一的吞咽困难患者被归类为患有非器质性或功能性吞咽困难。本研究旨在评估吞咽困难患者的症状严重程度、健康相关生活质量（HRQoL）和残疾情况。此外，研究重点评估了吞咽功能的软性内镜评估（FEES）及吞咽指导的影响，特别是针对功能性吞咽困难患者。我们从嗓音科诊所连续招募了60名吞咽困难患者。他们在预约就诊前完成了进食评估工具（EAT - 10）、15D健康相关生活质量量表和世界卫生组织残疾评估量表（WHODAS 2.0）问卷。我们进行了FEES并给予吞咽指导。一个月后，患者再次填写EAT - 10、15D和WHODAS 2.0。在1个月的随访中，所有60名吞咽困难患者（中位年龄65岁，范围18 - 89岁，70%为女性）以及功能性吞咽困难患者（n = 15，25%）的EAT - 10评分均显著降低（分别为p = 0.020，p = 0.029）。虽然15D和WHODAS 2.0评分的变化不显著，但功能性吞咽困难组中关于进食的WHODAS 2.0项目D3.3评分显著降低（p = 0.020）。将整个吞咽困难患者队列与按年龄和性别标准化的普通人群样本进行比较，发现15D总分（p < 0.001）以及15个维度中的12个维度存在显著差异。与普通人群相比，吞咽困难似乎会显著降低患者健康相关生活质量。短期的FEES干预及吞咽指导可能会缓解症状，尤其是在功能性吞咽困难患者中。
