Imperial College London
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Professor Justin Roe

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice (Speech and Swallowing Rehabilitation)
 
 
 
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Contact

 

justin.roe

 
 
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Location

 

Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Haywood:2021:10.1111/coa.13820,
author = {Haywood, M and Lovell, L and Roe, J and Clunie, G and Sandhu, G and Al, Yaghchi C},
doi = {10.1111/coa.13820},
journal = {Clinical Otolaryngology},
pages = {1229--1236},
title = {Perioperative instrumental swallowing evaluation in adult airway reconstruction: a retrospective observational cohort study},
url = {http://dx.doi.org/10.1111/coa.13820},
volume = {46},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ObjectivesAirway reconstruction for laryngotracheal stenosis (LTS) encompasses several procedures. Dysphagia is a well-recognised sequela of LTS and airway surgery, however studies have employed mostly non-validated assessments post-operatively in small, heterogenous samples, perpetuating uncertainty around the contributions of LTS and its management to impaired deglutition. Consequently, considerable variation in LTS perioperative nutritional management exists. Our objective was to characterise baseline and post-operative dysphagia with instrumental assessment in an LTS cohort undergoing airway reconstruction and provide a gold-standard management framework for its management.Design, setting, participants and main outcome measuresWe performed a retrospective cohort study of adult airway reconstruction procedures from 2016-2020 at our quaternary centre. Patient background, LTS aetiology, procedure type, tube feeding duration, length of stay and serial Functional Oral Intake Scale (FOIS) and International Dysphagia Diet Standardisation Initiative (IDDSI) scores were noted. Baseline, post-operative day one and post-stent removal Fibreoptic Endoscopic Evaluation of Swallow (FEES) generated Penetration Aspiration Scale (PAS) scores.ResultsForty-four patients underwent forty-six reconstructions. Baseline incidence of penetration-aspiration was considerably higher than the general population and worsened in the immediate post-operative period, however FOIS and PAS scores generally returned to baseline by discharge. Post-operative FOIS correlated negatively with tracheostomy or airway stent placement. At discharge, 80% tolerated soft or normal diet and 93% were feeding tube independent.ConclusionsWe present the largest adult airway reconstruction cohort with instrumental swallow assessment perioperatively. LTS patients have a higher incidence of underlying dysphagia but swallowing tends to return to baseline with appropriate postoperative rehabilitation. Such practice may
AU  - Haywood,M
AU  - Lovell,L
AU  - Roe,J
AU  - Clunie,G
AU  - Sandhu,G
AU  - Al,Yaghchi C
DO  - 10.1111/coa.13820
EP  - 1236
PY  - 2021///
SN  - 1749-4478
SP  - 1229
TI  - Perioperative instrumental swallowing evaluation in adult airway reconstruction: a retrospective observational cohort study
T2  - Clinical Otolaryngology
UR  - http://dx.doi.org/10.1111/coa.13820
UR  - https://onlinelibrary.wiley.com/doi/10.1111/coa.13820
UR  - http://hdl.handle.net/10044/1/89843
VL  - 46
ER  -
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