Effectiveness of Outpatient Treatment in Ear, Nose, and Throat Clinics for Dysphagia and the Role of Questionnaires

TL;DR

This study shows that outpatient treatment for swallowing difficulties in ENT clinics can be effective, with questionnaires helping to track symptoms but not predicting outcomes accurately.

Contribution

The study evaluates outpatient dysphagia treatment effectiveness and the role of questionnaires in ENT clinics, which is under-researched.

Findings

22 patients undergoing outpatient rehabilitation showed improvement in symptoms or swallowing assessments.

Questionnaires were useful for screening but not reliable for predicting treatment outcomes.

Some patients improved only in subjective symptoms, not in objective swallowing evaluations.

Abstract

Background

While most research on dysphagia treatment has focused on inpatients, less attention has been given to outpatient settings, particularly in ear, nose, and throat (ENT) clinics. Additionally, while questionnaires are commonly used as screening tools in dysphagia management, their correlation with outcomes such as pneumonia incidence or sustained oral intake is rarely discussed. This study aimed to evaluate the effectiveness of outpatient treatment in ENT clinics for dysphagia, including improvement in subjective symptoms, and to assess the role of the questionnaire.

Methodology

In total, 59 patients (38 males and 21 females) aged 53-93 years (mean age = 79 years) attended the outpatient swallowing clinic. All participants retained sufficient ability in activities of daily living to independently visit the hospital and could orally ingest food, and none required tube feeding. Subjective symptoms were evaluated using the questionnaire. Swallowing assessments were conducted by an otolaryngologist and via swallowing endoscopy. A speech-language pathologist led the swallowing rehabilitation, which included encouraging family involvement and home practice.

Results

The most frequent issue reported was munching during meals. Of the 59 patients, 22 underwent continuous outpatient rehabilitation. Of these, 17 (77%) showed improvement; 11 had improvement in both subjective symptoms and fiberoptic endoscopic evaluation of swallowing (FEES) scores, five in subjective symptoms only, and one in FEES scores only. Five patients showed no change/worsening conditions.

Conclusions

The questionnaire proved useful as a screening tool but fell short in terms of prognosis estimation. The findings suggest that information from the questionnaire should be used to gauge treatment effectiveness, noting that some cases showed improvement in subjective symptoms alone.

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