Laryngeal sarcoidosis and swallowing: what do we know about dysphagia assessment and management in this population?
File(s)
Published version
Author(s)
Lovell, Lindsay
Clunie, Gemma M
Al-Yaghchi, Chadwan
Roe, Justin
Sandhu, Guri
Type
Journal Article
Abstract
Introduction
Sarcoidosis is a chronic granulomatous disease of unknown aetiology and laryngeal involvement is seen in a small percentage of cases. Dysphagia is a common but under-reported symptom. Little is known about how dysphagia typically presents or is managed in the context of this fluctuating disease. We present our case series using an SLT-led model of assessment and management.
Methods
A literature search was conducted for any articles that reported both laryngeal sarcoidosis and dysphagia. We then analysed a case series of laryngeal sarcoidosis patients treated at Charing Cross Hospital. We report on multidimensional swallowing evaluation and rehabilitative interventions.
Results
Seventeen papers report both laryngeal sarcoidosis and dysphagia, with only one paper giving details on the nature of the dysphagia and the treatment provided.
In our case series (n = 7), patients presented with FOIS Scores ranging from 5 to 7 pre-operatively (median = 6). Aspiration (median PAS Score = 6 and Range = 3–8) and pharyngeal residue were common. Sensory issues were also prevalent with most unaware of the extent of their difficulties. Management interventions included safe swallowing advice, compensatory strategies, exercises and close surveillance given their potential for repeated surgical interventions.
Conclusion
Laryngeal sarcoidosis is a rare condition. Dysphagia is under-reported and our experience highlights the need for specialist dysphagia intervention. Further research is required to understand dysphagia management requirements in the context of this fluctuating disease process.
Sarcoidosis is a chronic granulomatous disease of unknown aetiology and laryngeal involvement is seen in a small percentage of cases. Dysphagia is a common but under-reported symptom. Little is known about how dysphagia typically presents or is managed in the context of this fluctuating disease. We present our case series using an SLT-led model of assessment and management.
Methods
A literature search was conducted for any articles that reported both laryngeal sarcoidosis and dysphagia. We then analysed a case series of laryngeal sarcoidosis patients treated at Charing Cross Hospital. We report on multidimensional swallowing evaluation and rehabilitative interventions.
Results
Seventeen papers report both laryngeal sarcoidosis and dysphagia, with only one paper giving details on the nature of the dysphagia and the treatment provided.
In our case series (n = 7), patients presented with FOIS Scores ranging from 5 to 7 pre-operatively (median = 6). Aspiration (median PAS Score = 6 and Range = 3–8) and pharyngeal residue were common. Sensory issues were also prevalent with most unaware of the extent of their difficulties. Management interventions included safe swallowing advice, compensatory strategies, exercises and close surveillance given their potential for repeated surgical interventions.
Conclusion
Laryngeal sarcoidosis is a rare condition. Dysphagia is under-reported and our experience highlights the need for specialist dysphagia intervention. Further research is required to understand dysphagia management requirements in the context of this fluctuating disease process.
Date Issued
2021-05-26
Date Acceptance
2021-04-20
Citation
Dysphagia, 2021, 37, pp.548-557
ISSN
0179-051X
Publisher
Springer Science and Business Media LLC
Start Page
548
End Page
557
Journal / Book Title
Dysphagia
Volume
37
Copyright Statement
© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/
License URL
Identifier
https://link.springer.com/article/10.1007%2Fs00455-021-10305-4
Subjects
Science & Technology
Life Sciences & Biomedicine
Otorhinolaryngology
Laryngeal sarcoidosis
Dysphagia
MANIFESTATIONS
RADIOTHERAPY
DIAGNOSIS
Dysphagia
Laryngeal sarcoidosis
Deglutition
Deglutition Disorders
Humans
Larynx
Sarcoidosis
Larynx
Humans
Deglutition Disorders
Sarcoidosis
Deglutition
1103 Clinical Sciences
Speech-Language Pathology & Audiology
Publication Status
Published
Date Publish Online
2021-05-26