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La acalasia esofágica es una patología infrecuente en la edad pediátrica. Su presentación clínica es insidiosa, lo que causa un retraso en el diagnóstico. Se presenta un caso de acalasia esofágica en una niña de 16 años, que tuvo la demora característica en la consulta y el diagnóstico. A pesar de que se describe la dilatación neumática con balón como la mejor opción terapéutica para la acalasia tipo II, en nuestra paciente fue inefectiva y requirió miotomía extramucosa de Heller con funduplicatura gastroesofágica antirreflujo.

Esophageal achalasia is an uncommon disease in pediatrics. With an insidious clinical presentation, diagnosis is delayed. Here we describe a case of esophageal achalasia in a 16-year-old girl, with the typical delay in consultation and diagnosis. Although pneumatic balloon dilatation has been described as the best therapeutic option for type II achalasia, it was ineffective in our patient and she required Heller extramucosal myotomy with gastroesophageal fundoplication for reflux.

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Introdução: A implementação do International Dysphagia Diet Standardization Initiative (IDDSI) é uma importante ferramenta para a padronização de texturas dos alimentos e líquidos para indivíduos com disfagia. Método: Esta revisão narrativa teve como objetivo identificar a utilização do IDDSI como padronização das texturas utilizadas na avaliação da deglutição, possibilitando compreender a relevância na prática clínica e na pesquisa. Realizou-se busca em janeiro/2024 nas bases de dados Medical Literature Analysis and Retrievel System Online, Scopus, Web of Science, Cochrane Library, Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Google Scholar. Resultados: Foram encontrados 560 artigos, excluídos 384 (duplicata) e 144 resumos devido aos critérios de inclusão. Foram selecionados para leitura completa 32 artigos e admitidos 23. Houve um aumento (700%) no número de publicações (2018-2023), com a participação de países como Brasil, EUA, China, Canadá. Foram analisados 14 estudos com adultos/idosos e um estudo em pediatria. Houve preferência por utilização de níveis 0 a 4, segurança da deglutição com níveis≥2, iniciativa sendo utilizada durante a avaliação, como marcador de evolução clínica e em recomendações dietéticas. Considerações finais: Observou-se o aumento de pesquisas com o IDDSI nas avaliações da deglutição e a diversidade de países utilizando a iniciativa. Foram poucos estudos em pediatria. Houve preferência por utilização de níveis líquidos, nem sempre relatado nível e volume. A metodologia do IDSSI para alcançar a textura adequada e reprodutível foi mais eficaz que a NDD. Mantém-se a necessidade de realizar estudos com populações e métodos homogêneos. (AU)

Introducción: La implementación del IDDSI (Iniciativa Internacional de Estandarización de la Dieta para la Disfagia) es una herramienta importante para estandarizar las texturas de alimentos y líquidos para personas con disfagia. Método: Revisión narrativa con el objetivo de identificar el uso del IDDSI como una estandarización de las consistencias de los alimentos para evaluación de la deglución, permitiendo comprender su relevancia en la práctica clínica/investigación. Se realizó una búsqueda (enero/2024) en las bases de datos Medical Literature Analysis and Retrievel System Online, SCOPUS, Web of Science, Literatura Latino-Americana y del Caribe em Ciências da Saúde, Scientific Electronic Library Online, Cochrane Library y Google Scholar. Resultados: Se encontraron 560 artículos, excluidos 384 (duplicados), 144 resumen (sin criterios de inclusión), 32 32 artículos completos para ler, se admitieron 23. Hubo un aumento (700%) en el número de publicaciones, con la participación de países como Brasil, EUA, Canada. Se analizaron 14 estudios con adultos/ancianos y un estudio en pediatría. Preferencia por los niveles 0-4, seguridad de la deglución con niveles≥2, utilizada para la evaluación, marcador de la evolución clínica y en las recomendaciones dietéticas. Consideraciones finales: Ha habido un aumento de la investigación y de países que utilizan la IDDSI en las evaluaciones de la deglución. Se han realizado pocos estudios en pediatria, una preferencia por el uso de líquidos, y no siempre se informó el nível/volumen. La metodología IDSSI para conseguir una textura adecuada y reproducible fue más eficaz que la NDD. Sigue siendo necesario realizar estudios con poblaciones y métodos homogéneos. (AU)

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Resumen Las enfermedades del esófago pueden presentar una incidencia y prevalencia extremadamente baja. Por lo tanto, es fundamental contar con equipos multidis ciplinarios que incluyan cirujanos especializados en afecciones esofágicas, con un alto volumen de casos, para garantizar un diagnóstico y manejo adecuados. En este estudio, se analizan casos de enfermedad esofágica con resultados satisfactorios y una resolución atípica. La falta de derivación a especialistas a tiempo puede llevar a una ausencia de diagnóstico o una baja calidad de vida para los pacientes. Estos hallazgos subrayan la importancia de disponer de cirujanos especializados en esófago y equipos mul tidisciplinarios para asegurar la mejor atención posible para los pacientes.

Abstract Esophageal pathologies can exhibit extremely low incidence and prevalence rates. Therefore, it is essential to have multidisciplinary teams including surgeons spe cialized in esophageal pathology, with a high caseload, to ensure proper diagnosis and management. This manuscript presents a series of esophageal pathology cases with favorable outcomes and atypi cal resolution for non-specialized groups. However, failure to refer to specialists in a timely manner can result in missed diagnoses or poor quality of life for patients. These findings underscore the importance of hav ing surgeons specialized in esophageal pathology and multidisciplinary teams to provide the best possible care for patients. Lusoria dysphagia (LD) is a condition caused by vas cular compression of the esophagus, resulting from the most common embryological vascular abnormality of the aortic arch: the aberrant right subclavian artery (ARSA) or lusoria artery (LA). This variant occurs in 0.5 to 2.5% of individuals. Necrosis of the gastric tube following an esophagec tomy is a rare complication with a high mortality rate. Esophageal replacement with coloplasty is the preferred technique for a second attempt at reconstruction. How ever, this remains a complex surgery with a high rate of complications.

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Background: Esophageal cancer (EC) is an extremely aggressive tumor with one of the highest geographic, ethnic, and gender variations. Various factors including tobacco consumption, unhealthy diet, and socioeconomic status have been implicated in the etiology of EC. Despite the advent of modern treatments, the prognosis of EC is dismal. This study has been undertaken to review the clinical and pathologic profiles, treatment approach, and survival pattern in patients with EC in a tertiary care hospital in northeast India. Materials and Methods: A retrospective descriptive study was done with 179 EC patients presented to our department between January 2013 and December 2020. Statistical analysis was done by using IBM Statistical Package for the Social Sciences version 21.P- value <0.05 was considered significant. Results: The majority of the patients presented in the sixth decade of life from rural areas with male to female ratio of 3.7:1. Dysphagia was the most common presenting feature. High incidence of tobacco and alcohol use was found. Mid-esophagus is the most common site and squamous cell carcinoma is the most common type. Fifty-two (29.1%) and 71 (39.6%) patients presented in stages III and IV, respectively. Twenty-four (13.4%) patients presented with metastatic disease, the lung being the most common site. Patients were treated with surgery, chemotherapy, radiotherapy, or combination of any of these. Overall median survival for the EC patients was 6 months. Patients treated with concurrent chemoradiation had better survival. Conclusion: EC is a serious malignancy with a dismal prognosis due to the advanced stage at presentation. Larger clinical trials using new therapeutic strategies are the need of the hour.

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Zenker's diverticulum (ZD) is the most common esophageal diverticulum. Its prevalence is higher in older adults. It arises in the area called Killian's triangle, which is an area of weakness in the posterior wall of the upper esophagus, at the level of the upper esophageal sphincter (UES). This area is delimited by the fibers of the thyropharyngeal muscle laterally and by the fibers of the cricopharyngeal muscle (CPM) in the inferior. Due to its composition, it is classified as a false diverticulum because it contains mucosal and submucosal layers in its walls. The predominant symptom in 90% of patients is dysphagia, followed by regurgitation of undigested food content. We present the case of the successful diagnostic approach with tomography and esophageal-gastro-duodenal and therapeutic series with diverticulectomy plus myotomy with the use of a stapler to a patient with usual symptoms of ZD, but with an unusual size: a giant ZD.

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Purpose: To evaluate the feasibility of sparing the dysphagia?aspiration?related structures (DARS) in various head and neck cancer sites treated with definitive DARS?optimized intensity modulated radiation therapy (IMRT) and concurrent chemotherapy. Materials and Methods: Target volumes, organs at risk, and in addition, individual DARS were delineated, including the superior, middle, and inferior pharyngeal constrictor muscles, supraglottic and glottic larynx, the base of the tongue, esophageal inlet muscles and cervical esophagus in 35 patients with head and neck squamous cell carcinoma. Volume?based dose constraints were applied to the DARS outside the planning target volume (PTV). An IMRT plan was then generated to limit doses to DARS without compromising PTV dose coverage. Results: Twelve (34.3%) patients had an oropharyngeal primary (OPX), 18 (51.4%) had a laryngeal, and 5 (14.3%) patients had hypopharyngeal primary. The mean dose to the DARS was 47.93 Gy for the entire group, while it was 54.6 Gy in oropharyngeal primaries and 44.4 Gy in laryngopharyngeal primaries. DARS mean dose of ?45 Gy could be achieved in a significantly lesser number of patients with oropharyngeal primaries (P < 0.02). Similarly, DARS mean dose was 42.25 Gy in patients with N0 disease, 49.6 Gy with ipsilateral involved nodes, and 55 Gy with bilateral disease. Sparing of DARS was feasible when the volume of PTV was ?150 cc (P < 0.025). Conclusion: Sparing of DARS structures appears to be challenging in patients with oropharyngeal cancers without compromising the dose to the PTVs while it is feasible in laryngopharyngeal cancers. DARS sparing is feasible when the PTV volume is < 150 cc and in patients with negative or unilateral nodal disease.

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Introdução: O enfisema pulmonar e a bronquite crônica são condições pulmonares conhecidas como Doença Pulmonar Obstrutiva Crônica (DPOC). Dentre os sintomas tem-se a dispneia e a tosse, o que pode impactar na coordenação entre a respiração e a deglutição, com provável comprometimento na alimentação. Objetivo: Relatar a associação do risco de transtorno de deglutição (RTD) em pacientes com DPOC sem acompanhamento fonoaudiológico. Método: Estudo transversal, retrospectivo (2001-2011) com análise de dados secundários de pacientes do ambulatório de pneumologia. As variáveis analisadas foram sexo, idade, tempo de diagnóstico da doença e comorbidades. Foi considerada como RTD a presença de pelo menos um dos critérios: modificação na consistência do alimento ingerido, alteração no volume da ingestão por via oral, uso de via alternativa de alimentação e oxigênio domiciliar. Resultados: Verificou-se RTD em 60% dos prontuários analisados. O RTD foi associado à idade (p=0,009) e ao comprometimento pulmonar relacionado ao enfisema (p = 0,041). Paciente com RTD apresentaram prevalência de utilização de oxigênio domiciliar (46,7%; p<0,001) comparados àqueles sem RTD. Conclusão: Pacientes com DPOC em seguimento ambulatorial apresentaram alta prevalência de risco para transtorno de deglutição, estando estes riscos associados a pacientes com maior idade e com comprometimento relacionado ao enfisema pulmonar. Sabemos que há publicações relacionando DPOC e disfagia, sobre a importância da avaliação fonoaudiológica, mas ainda há necessidade de mais publicações sobre o tema, para aumentar o alerta dos profissionais de saúde, da necessidade dos atendimentos desses pacientes. (AU)

Introduction: Pulmonary emphysema and chronic bronchitis are lung conditions known as chronic obstructive pulmonary disease (COPD). Symptoms include dyspnea and coughing, which can impact the breathing/swallowing coordination, possibly impairing eating. Objective: To report the association of the risk of swallowing disorders (RSD) in patients with COPD without speech-language-hearing follow-up. Method: Cross-sectional, retrospective study (2001-2011) with secondary data analysis from patients at a pulmonology outpatient clinic. The variables analyzed were sex, age, time since disease diagnosis, and comorbidities. Having at least one of the following criteria was considered as RSD: change in the food consistency, change in the oral intake volume, use of an alternative feeding route, and home oxygen. Results: RSD was found in 60% of the analyzed medical records. It was associated with age (p=0.009) and pulmonary involvement due to emphysema (p=0.041). Patients with RSD had a prevalence of home oxygen use (46.7%; p<0.001) compared to those without RSD. Conclusion: Patients with COPD in outpatient follow-up had a high prevalence of risk of swallowing disorders, associated with older patients and impairment due to pulmonary emphysema. Some publications relating COPD to dysphagia have addressed the importance of speech-language-hearing assessment. However, more publications on the subject are needed to raise health professionals' awareness of these patients' care needs. (AU)

Introducción: El enfisema pulmonar y la bronquitis crónica son afecciones pulmonares conocidas como enfermedad pulmonar obstructiva crónica (EPOC). Los síntomas incluyen disnea y tos, que pueden repercutir en la coordinación entre la respiración y la deglución, con probable afectación de la alimentación. Objetivo: Informar sobre la asociación entre el riesgo de trastornos de la deglución (RTD) en pacientes con EPOC sin seguimiento logopédico. Método: Estudio transversal, retrospectivo (2001-2011) analizando datos secundarios de pacientes de la consulta externa de neumología. Las variables analizadas fueron sexo, edad, tiempo desde el diagnóstico y comorbilidades. Se consideró RTD la presencia de al menos uno de los siguientes criterios: cambio en la consistencia de los alimentos ingeridos, cambio en el volumen de ingesta oral, uso de una vía de alimentación alternativa y oxígeno domiciliario. Resultados: Se encontró RTD en el 60% de los pacientes. El RTD se asoció con la edad (p=0,009) y con el deterioro pulmonar relacionado con el enfisema (p=0,041). Los pacientes con RTD presentaban una mayor prevalencia de uso de oxígeno domiciliario (46,7%; p<0,001) en comparación con aquellos sin RTD. Conclusión: Los pacientes con EPOC en seguimiento ambulatorio presentaron una alta prevalencia de RTD, y estos riesgos se asociaron a pacientes de mayor edad y a alteraciones relacionadas con el enfisema pulmonar. Sabemos que existen publicaciones que relacionan EPOC y disfagia, sobre la importancia de la valoración logopédica, pero aún son necesarias más publicaciones sobre el tema, para concienciar a los profesionales sanitarios de la necesidad de atender a estos pacientes. (AU)

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RESUMEN El cáncer de esófago corresponde a una neoplasia maligna con un pobre pronóstico. Los tumores neuroendócrinos de esófago son muy poco frecuentes y representan menos del 2%. Cuando se manifiesta clínicamente con disfagia permanente, progresiva y repercusión general, habitualmente corresponden tumores localmente avanzados con mal pronóstico. Se presenta el caso de un hombre de 45 años que consulta por disfagia permanente y progresiva, en el cual se realizó diagnóstico de carcinoma neuroendocrino de esófago. Se arribó al diagnóstico mediante la endoscopia que evidenció una lesión extensa, vegetante y estenosante que ocupaba tres cuartos de la circunferencia del esófago. La histología confirmó el diagnóstico de neoplasia maligna pobremente diferenciada a células pequeñas con inmunohistoquímica positiva para cromogranina A y sinaptofisina. Ante el diagnóstico de carcinoma neuroendocrino de esófago a células pequeñas con extensión locorregional, estadio IV, se planteó tratamiento paliativo con quimioterapia, radioterapia y gastrostomía endoscópica percutánea, con sobrevida de tan solo 6 meses.

ABSTRACT Oesophageal cancer corresponds to a malignant neoplasm with a poor prognosis. Neuroendocrine tumors of the esophagus are very rare, accounting for less than 2%. When clinically manifested by permanent, progressive dysphagia and general impact, they usually correspond to locally advanced tumors with a poor prognosis. We present the case of a 45-year-old man who attended medical attention for persistent and progressive dysphagia, who was diagnosed with neuroendocrine carcinoma of the oesophagus. The diagnosis was reached through endoscopy, revealing an extensive, vegetative and stenosing lesion occupying three-quarters of the oesophageal circumference. Histology confirmed the diagnosis of poorly differentiated small cell malignancy with positive immunohistochemistry for chromogranin A and synaptophysin. In light of the diagnosis of small cell neuroendocrine carcinoma of the oesophagus with locaregional extension, stage IV, palliative treatment with chemotherapy, radiotherapy and percutaneous endoscopic gastronomy was proposed, with a survival of only 6 months.

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Hoarseness is a commonly encountered symptom with several underlying causes ranging from idiopathic to potentially severe diseases. Cardio-vocal syndrome/Ortner syndrome (OS) is a rare entity that presents a challenge due to its tendency to evade detection over prolonged periods. Ortner syndrome, characterized by swallowing difficulty due to extrinsic compression of the esophagus by an atherosclerotic thoracic aorta, further adds to the complexity of the diagnosis. Here we report a case of OS and dysphagia aortica in a 62-year-old male with a history of chronic smoking and cardiovascular comorbidities. This case emphasizes the significance of considering cardiovascular etiologies in unilateral vocal cord paralysis (UVCP) evaluation.

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Introdução: O Transtorno do Espectro Autista (TEA) é um distúrbio do neurodesenvolvimento caracterizado por déficits na comunicação social, alterações de sensibilidade e dificuldades alimentares.Objetivo: Realizar uma revisão integrativa das alterações de deglutição em indivíduos com TEA.Métodos: A pesquisa foi realizada por meio de uma busca por artigos nacionais e internacionais, utilizando descritores para a pesquisa, bem como critérios de inclusão e exclusão para a seleção da amostra final. A estratégia PPOT foi utilizada para definir critérios de elegibilidade, incluindo população (crianças e adultos), preditor (diagnóstico de TEA), desfecho (relato ou diagnóstico de disfagia oral, faríngea ou esofágica) e tipo de estudo (estudos observatórios). A busca foi realizada no período de junho a agosto de 2023, nas bases de dados: Pubmed, Scopus, Embase e Google Scholar. Resultados: Foram selecionados dez estudos com pacientes diagnosticados com TEA que relataram sintomas de disfagia orofaríngea e esofágica, além de queixas sobre ingestão alimentar. Os estudos sugerem que crianças com TEA podem apresentar algum problema de disfunções motoras orais, frequência alimentar inadequada, padrões alimentares obsessivos, apresentação específica de determinados alimentos, seletividade alimentar e dificuldades de processamento sensorial. Conclusão: Conclui-se que não há evidências científicas robustas sobre a presença de disfagia em pacientes com TEA. (AU)

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication, changes in sensitivity and eating difficulties. Objective: To carry out an integrative review of swallowing changes in individuals with ASD. Methods: The research was carried out through a search for national and international articles, using descriptors for the research, as well as inclusion and exclusion criteria for selecting the final sample. The PPOT strategy was used to define eligibility criteria, including population (children and adults), predictor (ASD diagnosis), outcome (report or diagnosis of dysphagia oral, pharyngeal or esophageal), and study type (observatory studies). The search was carried out from June to August 2023, in the databases: Pubmed, Scopus, Embase and Google Scholar. Results: Ten studies were selected with patients diagnosed with ASD who reported symptoms of oropharyngeal and esophageal dysphagia, in addition to complaints about food intake. Studies suggest that children with ASD may present problems with oral motor dysfunction, inadequate eating frequency, obsessive eating patterns, specific presentation of certain foods, food selectivity and sensory processing difficulties. Conclusion: It is concluded that there is no robust scientific evidence about the presence of dysphagia in patients with ASD. (AU)

Introducción: El Trastorno del Espectro Autista (TEA) es un trastorno del neurodesarrollo caracterizado por déficits en la comunicación social, cambios en la sensibilidad y dificultades alimentarias. Objetivo: Realizar una revisión integradora de los cambios en la deglución en individuos con TEA. Métodos: La investigación se realizó mediante una búsqueda de artículos nacionales e internacionales, utilizando descriptores para la investigación, así como criterios de inclusión y exclusión para la selección de la muestra final. La estrategia PPOT se utilizó para definir los criterios de elegibilidad, incluida la población (niños y adultos), el predictor (diagnóstico de TEA), el resultado (informe o diagnóstico de enfermedad oral, faríngea o esofágica) y el tipo de estudio (estudios observatorios). La búsqueda se realizó de junio a agosto de 2023, en las bases de datos: Pubmed, Scopus, Embase y Google Scholar. Resultados: Se seleccionaron diez estudios con pacientes diagnosticados de TEA que refirieron síntomas de disfagia orofaríngea y esofágica, además de quejas sobre la ingesta de alimentos. Los estudios sugieren que los niños con TEA pueden presentar problemas de disfunción motora oral, frecuencia inadecuada de alimentación, patrones alimentarios obsesivos, presentación específica de ciertos alimentos, selectividad alimentaria y dificultades en el procesamiento sensorial. Conclusión: Se concluye que no existe evidencia científica robusta sobre la presencia de disfagia en pacientes con TEA. (AU)

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Introducción: La disfagia es una condición que afecta la eficiencia de la deglución de los alimentos. Mundialmente, una tercera parte de los ancianos padece de algún grado de disfagia, representando un alto riesgo de malnutrición debido a que las carentes opciones alimenticias destinadas a este público no satisfacensus requerimientos nutricionales. Objetivo: Esta investigación tuvo como objetivo desarrollar formulaciones de almuerzos con textura modificada para pacientes con disfagia, a partir de materias primas típicas dominicanas. Materiales y métodos: Se realizaron dos almuerzos de diferentes composiciones [sancocho (S) y arroz con habichuelas y carnes (AHC)] y viscosidades (néctar: 51-350 mPa.s; miel: 351-1,750 mPa.s y pudín: 1,751- 2,500 mPa.s), a los cuales se les evaluó el análisis químico aproximado y la aceptación sensorial. Se utilizó un diseño completamente al azar, bajo arreglo factorial (2 x 3). Resultados: Se evidenciaron diferencias entre las medias de los tratamientos (p<0.05) para el contenido de humedad y de carbohidratos en relación con las composiciones; el análisis por viscosidades presentó diferencias en el contenido de humedad, grasa, proteínas y carbohidratos, en cuanto a la interacción entre las composiciones y las viscosidades hubo similitudes estadísticas en el porcentaje de cenizas y grasas. Se encontró que los tratamientos más viscosos y la composición S fueron mejor valorados y que el desempeño sensorial global de los almuerzos fue satisfactorio. Conclusiones: El alimento (tipo crema) con materias primas dominicanas, sensorialmente aceptado, podría ser utilizado y también aceptado, en pacientes con disfagia(AU)

Introduction: Dysphagia is a condition that affects the efficiency of food swallowing. Globally, one-third of the elderly population suffers from some degree of dysphagia, representing a high risk of malnutrition due to the lack of dietary options tailored to their nutritional requirements. Objective: This research aimed to develop modified texture lunch formulations for dysphagia patients using typical Dominican raw materials. Materials and methods: Two lunches of different compositions [sancocho (S) and rice with beans and meat (AHC)] and viscosities (nectar: 51-350 mPa.s; honey: 351-1,750 mPa.s and pudding: 1,751-2,500 mPa.s) were made and evaluated for proximate chemical analysis and sensory acceptance. A completely randomized design was used, under factorial arrangement (2 x 3). Results: Differences were observed between treatment means (p<0.05) for moisture and carbohydrate content concerning compositions; viscosity analysis showed differences in moisture, fat, protein, and carbohydrate content, while compositional and viscosity interactions exhibited statistical similarities in ash and fat percentage. It was found that the more viscous treatments and composition S were better rated, and overall sensory performance of the lunches was satisfactory. Conclusions: The food (cream type) with Dominican raw materials, sensorially accepted, could be used and also accepted in patients with dysphagia(AU)

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Resumen Antecedentes: El deterioro cognitivo y la disfagia son comunes en personas mayores. Objetivo: Explorar las características de la disfagia mediante fluoroscopia en pacientes con deterioro cognitivo leve (DCL) y demencia. Material y métodos: Se analizaron 158 adultos de una clínica de memoria. Para evaluar el DCL y la demencia, se emplearon criterios específicos; y para la disfagia, la escala EAT-10. Se realizó fluoroscopia con trago de bario para evaluar las fases de la deglución; la presencia de broncoaspiración apoyó el diagnóstico de disfagia. Se realizó análisis de regresión logística para establecer la relación entre disfagia y DCL. Resultados: Según EAT-10, 86 pacientes (54.4 %) tenían riesgo de disfagia, la cual fue confirmada en 84 mediante fluoroscopia (53.8 % tenía DCL y 46.2 %, demencia). En el grupo con DCL se observó asociación inversa con alteraciones en la fase oral (RM = 0.23, p < 0.025) y asociación positiva con alteraciones en la protección contra la regurgitación (RM = 3.76, p < 0.056) y contracción del músculo laríngeo (RM = 3.22, p < 0.045) versus grupo con demencia. Conclusiones: El estudio mostró alta frecuencia de disfagia en pacientes con DCL, lo que resalta la importancia de su detección temprana para mejorar las complicaciones asociadas.

Abstract Background: Dysphagia and cognitive impairment are common in older people. It is linked to alterations in brain areas related to swallowing. Objective: To explore the characteristics of dysphagia using fluoroscopy in patients with mild cognitive impairment (MCI) and dementia. Material and methods: 158 participants from a memory clinic. Specific criteria for MCI and dementia were used. Dysphagia was assessed with EAT-10 (≥3). Those who accepted completed a fluoroscopy study with a barium swallow to evaluate the phases of swallowing; the presence of bronchoaspiration supported the diagnosis of dysphagia. A logistic regression analysis was performed to test the probability between dysphagia and MCI. Results: According to EAT-10, 86 (54.4 %) were at risk of dysphagia, confirmed in 84 by fluoroscopy, 53.8 % MCI group and 46.2 % dementia. An inverse association was observed in the MCI oral phase group (OR 0.23, p < 0.025), and a positive association; in protection phase against regurgitation (OR 3.76, p < 0.056) and laryngeal muscle contraction (OR 3.22, p < 0.045) versus dementia group. Conclusions: The study showed a high frequency of dysphagia in patients with MCI, this highlights the importance of its early detection to improve complications associated with dysphagia.

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Background: Most head and neck cancers arise from the mucosal epithelium of the oral cavity, pharynx, and larynx, and are collectively referred to as head and neck squamous cell carcinoma (HNSCC). Early-stage HNSCC are managed by surgery alone where whereas locally advanced cancers require multimodal treatment which involves surgery followed by adjuvant radiotherapy(RT) or chemoradiotherapy(CRT). Methods: The present study was conducted at the State Cancer Institute, Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, MP, India. About 60 patients of either sex, randomized into two groups of 30 patients in each group fulfilling the inclusion and exclusion criteria were scheduled to undergo radiation with Cisplatin. Arm A patients received accelerated fraction, while Arm B received conventional fraction. Result: Most patients in both arms were males aged 50-60. In both arms, most patients had primary lesions in the oral cavity and were classified as stage III. Mucositis was more severe in Arm A than in Arm B. All of the patients in both arms were suffering from dysphagia during treatment. Complete response was achieved by 55.56% of patients in Arm A and 48.57% in Arm B. Conclusion: It was concluded that an accelerated regimen could be preferred over a conventional one per the clinical response observed and toxicity management. Disease-free survival can be predicted using a large sample size and time.

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Abstract Objective: To examine the prevalence and characteristics of dysphagia and suck-swallow-breath incoordination as phenotypes of oral feeding difficulties. Method: A cross-sectional study with secondary data collected consecutively over 2 years from October 2020 to October 2022 to measure the prevalence of swallowing and oral feeding difficulty in preterm infants using Flexible endoscopic evaluation of swallowing examination at the tertiary Integrated Dysphagia Clinic. Results: The prevalence of swallowing disorders was 25 % and the prevalence of suck-swallow-breath incoordination was 62.5 %. The significant risk factor that may show a possible correlation with oral feeding difficulty was mature post-menstrual age (p = 0.006) and longer length of stay (p = 0.004). The dominant percentage of upper airway abnormality and disorder were retropalatal collapse (40 %), laryngomalacia (42.5 %), paradoxical vocal cord movement (12.5 %), and gastroesophageal reflux disease (60 %). The dominant characteristic of oral motor examination and flexible endoscopic evaluation of swallowing examination was inadequate non-nutritive sucking (45 %), inadequate postural tone (35 %), and inadequate nutritive sucking (65 %). Conclusion: Dysphagia in preterm infants is mostly observed in those with mature post-menstrual age, longer length of stay, and the presence of gastroesophageal reflux disease with inadequate non-nutritive sucking and nutritive sucking abilities. Suck-swallow-breath incoordination is primarily observed in those with immature post-menstrual age, a higher prevalence of cardiopulmonary comorbidity, and a higher prevalence of upper airway pathologies (laryngomalacia, paradoxical vocal cord movement) with inadequate nutritive sucking ability.

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Introducción: la disfagia es la alteración en los mecanismos de la deglución que coexiste con múltiples enfermedades y condiciones. El conocimiento amplio de esta alteración generará mejores diagnósticos y tratamientos para el mejoramiento de la calidad de vida de estos pacientes. Aunque esta alteración podría ser del dominio común por especialistas en el área de la salud, principalmente la oral, no existe información reciente del nivel de conocimiento sobre la disfagia en el personal odontológico. Objetivo: determinar el nivel de conocimiento sobre la disfagia en un grupo de profesionales de la salud oral de Ciudad Juárez, Chihuahua. Material y método: se realizó un estudio trasversal descriptivo en un grupo de 241 odontólogos (pasantes de servicio social, odontólogos generales, periodoncistas, endodoncistas, rehabilitadores, odontopediatras y ortodoncistas) a través de una encuesta, los reactivos utilizados fueron sobre conocimiento de la disfagia, métodos de diagnóstico, signos y síntomas, tratamiento y complicaciones. Resultados: la mitad de la población encuestada refirió conocer los trastornos de la deglución (64.7%). Contrastantemente, al utilizar el término «disfagia¼, la postura del conocimiento disminuyó considerablemente (40.7%). Finalmente, los valores más bajos de la encuesta se mostraron en la falta de conocimiento sobre identificación de signos y síntomas de la disfagia (36.1%), métodos de diagnóstico (20.7%), tratamientos (18.7%) y complicaciones (23.2%). Conclusión: existe un bajo conocimiento de los trastornos de la deglución autopercibido por los profesionales de la odontología, lo que sugiere la búsqueda de los factores que ocasionan la falta del conocimiento de los profesionales del área odontológica (AU)

Introduction: dysphagia is the alteration in swallowing mechanisms that coexists with multiple diseases and conditions. The broad knowledge of this alteration will generate better diagnoses and treatments for the improvement of the quality of life of these patients. Although this alteration could be common domain by specialists in the area of health, mainly oral, there is no recent information on the level of knowledge about dysphagia in dental personnel. Objective: to determine the level of knowledge about dysphagia in a group of oral health professionals from Ciudad Juárez, Chihuahua. Material and methods: a descriptive cross-sectional study was carried out in a group of 241 dentists (social service intern, general dentists, periodontists, endodontists, rehabilitators, pediatric dentists and orthodontists) through a survey, the reagents used were on knowledge of dysphagia, diagnostic methods, signs and symptoms, treatment and complications. Results: half of the surveyed population reported knowing swallowing disorders (64.7%). In contrast, when using the term «dysphagia¼ the posture of knowledge decreased considerably (40.7%). Finally, the lowest values in the survey were found in the lack of knowledge about identification of signs and symptoms of dysphagia (36.1%), diagnostic methods (20.7%), treatments (18.7%) and complications (23.2%). Conclusion: there is a low knowledge of self-perceived swallowing disorders by dentists, which suggests the search for the factors that cause the lack of knowledge of dental professionals (AU)

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SUMMARY: The thyrohyoid muscle is one of the four infrahyoid muscles. Its role in vocalization and deglutition could be often overlooked, despite its crucial participation in these processes. Unlike other infrahyoid muscles, the thyrohyoid muscle receives innervation from the first cervical spinal nerves which contributes to its unique function. Its primary action involves hyolaryngeal elevation during swallowing, contributing to the opening of the upper esophageal sphincter. In conjunction with other muscles, it also protects the airway and facilitates the passage of food into the esophagus. Variations in the muscle's thickness may exist, and its function can be influenced by chewing habits. Weakened muscles involved in swallowing are often associated with dysphagia, a common complication in stroke and brain-injured patients. Advanced imaging techniques and sleep studies have provided insights into the dynamics and frequency of swallowing. This review explores the anatomic structures, function in action, diagnosis and clinical implications of this muscle. Overall, understanding the significance of the thyrohyoid muscle enhances our comprehension of the intricate interplay of laryngeal muscles during vocalization and deglutition.

El músculo tirohioideo es uno de los cuatro músculos infrahioideos. A menudo podría pasarse por alto su papel en la vocalización y la deglución, a pesar de su participación crucial en estos procesos. A diferencia de otros músculos infrahioideos, el músculo tirohioideo recibe inervación de los primeros nervios espinales cervicales, lo que contribuye a su función única. Su acción principal implica la elevación hiolaríngea durante la deglución, contribuyendo a la apertura del esfínter esofágico superior. Junto con otros músculos, también protege las vías respiratorias y facilita el paso de los alimentos al esófago. Pueden existir variaciones en el grosor del músculo y su función puede verse influenciada por los hábitos de masticación. Los músculos debilitados involucrados en la deglución a menudo se asocian con disfagia, una complicación común en pacientes con accidente cerebrovascular y lesión cerebral. Las técnicas de imagen avanzadas y los estudios del sueño han proporcionado información sobre la dinámica y la frecuencia de la deglución. Esta revisión explora las estructuras anatómicas, la función en acción, el diagnóstico y las implicaciones clínicas de este músculo. En general, comprender la importancia del músculo tirohioideo mejora nuestra comprensión de la intrincada interacción de los músculos laríngeos durante la vocalización y la deglución.

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Objective: We aimed to determine the prevalence of self-reported swallowing difficulty (dysphagia) among older Colombians and to explore the factors associated with this condition. Methods: This study presents a secondary analysis of the SABE-Colombia survey, a crosssectional study of community-dwelling older adults. The dependent variable was self reported swallowing difficulty, assessed through the question: "How often do you have difficulty or discomfort swallowing?" Descriptive and bivariate analyses of the sample were performed, followed by multivariate analysis, adjusting for confounding variables. Results: The final sample included 19 004 older Colombians, whose mean age was 69 years (56% women). The overall prevalence of swallowing difficulty was 12.2%. In the multivariate analysis, significant associations were observed between swallowing difficulty and several factors, including male sex (OR 1.14, 95%CI 1.03 ­ 1.26), age > 80 years (OR 1.26, 95%CI 1.08 ­ 1.47), dependence in activities of daily living (OR 1.62, 95%CI 1.23 ­ 2.13), cognitive impairment (OR 1.49, 95%CI 1.30 ­ 1.70), depressive symptoms (OR 1.38, 95%CI 1.15 ­ 1.65), sarcopenia (OR 1.32, 95%CI 1.02 ­ 1.69), malnutrition (OR 1.35, 95%CI 1.23 ­ 1.49), and osteoarticular disease (OR 1.18, 95%CI 1.07 ­ 1.38). Conclusion: There was a high prevalence of swallowing difficulty among older community-dwelling Colombians. Our results showed a strong correlation between swallowing difficulty and risk factors such as cognitive impairment, depressive symptoms, osteoarticular disease, and dependence in activities of daily living, but not with malnutrition or sarcopenia. (AU)

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Background: Advanced head and neck cancers are known to cause swallowing dysfunction due to anatomical and post?treatment changes. Literature is sparse on post?surgical and/or multi?modality therapy?associated swallowing function in advanced oral cancers. We conducted this study to longitudinally assess and compare the pre? and post?therapy swallowing dysfunction associated with locally advanced oral cancers. Methods and Material: A prospective observational longitudinal study was conducted at a tertiary cancer center from 2017 to 2018 including treatment?naive cT4a oral cancer patients (AJCC 7th edition). The assessment was done pre?surgery, post?surgery, and post?adjuvant setting as per the scales (Dysphagia score, Penetration aspiration scale, and Yale pharyngeal residue (vallecular and pyriform fossa). Results: Of the 30 patients in the study, 47.4%, 47.4%, 52.6%, and 47.4% experienced deterioration of Dysphagia score, Penetration?Aspiration Scale (PAS), vallecula residue, and pyriform residue scores in the postoperative period. And 52.6%, 47.4%, 68.4%, and 57.9% had inferior dysphagia score, PAS, vallecula, and pyriform residue scores even 6 months after completion of adjuvant therapy. The dysphagia score correlated well with other objective assessment scores at different time points. Conclusion: Swallowing functions are significantly affected by surgery and adjuvant therapy and continue to be affected even 6 months after completion of treatment. Appropriate rehabilitation and intervention must be offered to patients to reduce this problem. Dysphagia scores can predict the swallowing status similar to other objective assessments.

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Objective To investigate the effect of early active cycle breathing technique(ACBT)on aspiration in patients with dysphagia after partial laryngectomy.Methods A total of 40 patients with laryngeal cancer with dysphagia who were hospitalized in the Department of Otorhinolaryngology of the Third Xiangya Hospital of Central South University in January 2019～January 2022 were selected,and the patients were randomly divided into 20 cases in the observation group and the control group by random number method,the control group was given routine swallowing function training,and the observation group was combined with active cycle of breathing technique(ACBT)on the basis of the control group.The two groups were treated 5 days a week,twice a day,45 minutes each for 2 weeks.The M.D.Anderson Dysphagia Inventory(MDADI),maximum phonation time(MPT),and Standardized Swallowing Assessment(SSA),flexible endoscopic examination of swallowing(FEES)combined with modified invasion and aspiration score(MPAS score)and overall clinical efficacy before and after treatment were compoued between the two groups.Results After 2 weeks of treatment,the swallowing function of both groups improved,but the MDADI scores in the observation group were better than those of in the control group in all cate-gories(P＜0.001),MPT(7.19±1.31)was better than that of the control group(4.29±0.88)(=9.436,P＜0.001),SSA(19.25±1.12)was better than that of the control group(21.20±2.55)(=-2.894,P＜0.05),and FEES combined with MPAS score(1.75±0.85)was better than the control group(2.70±1.34)(=-2.674,P＜0.001),and the overall clinical efficacy(18,90.00％)was better than the control group(12,60.00％)(Z=-3.894,P＜0.001).Conclusion Early application of active breathing and circulation technique combined with swallowing training can improve the swallowing function of patients to a greater extent and reduce the incidence of aspiration compared with swallowing function training alone.

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Objective To analyze the current status,hot spots and trends of Chinese and English researches in the field of aspiration after dysphasia in the past twenty years. Methods The articles about aspiration after dysphasia were retrieved from CNKI and Web of Science(WOS)core collec-tion database,from January,2003 to June,2023,and were analyzed with CiteSpace 6.1.R6. Results A total of 3 231 articles were included.The annual articles were published more and more year by year.The most English literatures came from the United States.Hot spots mainly focused on the assessment of dysphasia,prevention of complication,nutrition and rehabilitation therapy.It would concentrate on the application of the volume-viscosity swallow test and assessment scales,rehabilitation,penetration aspiration,outcome and effect validation,quality of life,feeding and nutrition condition,and evidence-based nursing,etc.,in the future. Conclusion The researches in the field of aspiration after dysphasia have been increasing in recent years,and the themes and contents of researches have been deepening.