Background Dysphagia is a common problem in HD.1,2,3 Swallowing function becomes increasingly impaired, increasing the risk of aspiration and pneumonia, the most common cause of mortality.3 An evidence-based rationale for the development and evaluation of timely and complex SLT interventions is required to confirm that swallow training is beneficial in HD and at what disease stages interventions are most likely to be beneficial. This also helps to choose reliable and feasible outcome-measures, including instrumental assessments visualising the structure and function of different stages of swallow.
collect longitudinal data to assess the features of the dysphagia in HD
identify possible risk factors for severity of the dysphagia and aspiration
evaluate a range of dysphagia related outcome measures
Methods We investigated 61 patients retrospectively and 25 patients prospectively to describe features of the swallowing disorder (such as residues, leaking, penetration/aspiration) dependent on consistencies and their correlation with the motor stage of HD. For clinical swallowing examination we used the NOD-Stepwise Concept.4 Instrumental assessment to visualise the structure and functions of the different stages of swallowing and to identify the risk of aspiration was Fiberoptic Endoscopic Evaluation of Swallowing (FEES). The examination was complemented by the Swallowing Quality of life survey (SWAL-QOL).5
Results Subclinical Dysphagia was found in HD patients at all stages of the disease. Clinical predictors like dysarthria and dysphonia for the risk of aspiration as well as effective compensatory strategies were identified.
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- SWALLOWING DISORDER