Boggiano Sarah, Freeman-Sanderson Amy, Miles Anna, Power Emma, Rogers Kris, Wallace Sarah
Discipline of Speech Pathology, Graduate School of Health, Faculty of Health, University of Technology Sydney, PO Box 123 Broadway, Sydney, NSW, Australia.
Speech Pathology Department, Royal North Shore Hospital, Sydney, Australia.
Dysphagia. 2025 Sep 22. doi: 10.1007/s00455-025-10884-6.
To identify in the literature which pharyngolaryngeal abnormalities (PLA) co-occur or are associated with oropharyngeal dysphagia when viewed via nasoendoscopy. Flexible Endoscopic Evaluation of Swallowing (FEES) is an examination used to assess swallowing. Currently there are no standardized frameworks to observe and report on PLAs observed during a FEES procedure to support diagnostics and inform management. Multiple databases (Scopus (Elsevier), Medline (Ovid), CINAHL (EBSCO) and EMBASE (Ovid)) were searched against inclusion criteria from 1980 to 2024. Key search terms included variations of larynx, pharynx, FEES, and oropharyngeal dysphagia. The study utilized PRISMA-ScR reporting items. Two independent reviewers screened in two phases. Reporting of PLAs with oropharyngeal dysphagia was represented using frequency of co-occurrence and, where available, any statistical analyses attempting to demonstrate an association. Prevalence was calculated for PLA and presence of signs/symptoms of oropharyngeal dysphagia. 117 articles were included for full text review. Data were synthesized into 24 PLA within six categories. PLAs with both frequency of co-occurrence and statistical analysis attempting to demonstrate an association with oropharyngeal dysphagia included unilateral vocal fold motion impairment (UVFMI), velopharyngeal insufficiency, arytenoid motion impairment, incomplete glottic closure, vocal fold atrophy/bowing, edema, and hematoma. This scoping review presents evidence relating to PLAs seen via nasoendoscopy and their reported co-occurrence with oropharyngeal dysphagia. Overall, seven PLA were shown to have an association with oropharyngeal dysphagia, and a further 11 PLA had frequency of co-occurrence with oropharyngeal dysphagia without statistical analysis to support association. Whilst these findings suggest a relationship between PLA and oropharyngeal dysphagia, further research is required to confirm causation of each PLA on swallowing function. Systematic swallowing assessment and use of outcome measures that consider the presence of pharyngolaryngeal abnormalities, will help generate rigorous evidence that is needed to advance precision in diagnostics of swallowing impairment and subsequent interventions.
通过鼻内镜检查确定文献中哪些咽喉部异常（PLA）与口咽吞咽困难同时出现、相关或有关联。吞咽功能的软性内镜评估（FEES）是一种用于评估吞咽的检查。目前尚无标准化框架来观察和报告在FEES检查过程中观察到的PLA，以支持诊断并为管理提供信息。针对1980年至2024年的纳入标准对多个数据库（Scopus（爱思唯尔）、Medline（Ovid）、CINAHL（EBSCO）和EMBASE（Ovid））进行了检索。关键检索词包括喉、咽、FEES和口咽吞咽困难的变体。该研究采用PRISMA-ScR报告项目。两名独立的评审员分两个阶段进行筛选。口咽吞咽困难伴PLA的报告以同时出现的频率表示，并在可行的情况下，用任何试图证明关联的统计分析表示。计算PLA以及口咽吞咽困难体征/症状的患病率。纳入117篇文章进行全文评审。数据被综合为六个类别中的24种PLA。同时出现频率以及有试图证明与口咽吞咽困难相关的统计分析的PLA包括单侧声带运动障碍（UVFMI）、腭咽闭合不全、杓状软骨运动障碍、声门闭合不全、声带萎缩/弓状变形、水肿和血肿。这项范围综述提供了通过鼻内镜检查所见PLA及其报告的与口咽吞咽困难同时出现情况的证据。总体而言，七种PLA显示与口咽吞咽困难有关联，另有11种PLA与口咽吞咽困难同时出现但无统计分析支持关联。虽然这些发现表明PLA与口咽吞咽困难之间存在关系，但需要进一步研究来证实每种PLA对吞咽功能的因果关系。系统的吞咽评估以及使用考虑咽喉部异常情况的结果测量方法，将有助于产生推进吞咽障碍诊断精度及后续干预所需的严格证据。
