Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 11/2023

17-08-2023 | Dysphagia | Review Article

Evaluation of outcome measures for post-operative dysphagia after anterior cervical discectomy and fusion

Authors: Wasef Nijim, J. Harrison Cowart, Christopher Banerjee, Gregory Postma, Michel Paré

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2023

Login to get access

Abstract

Purpose

The goal is to conduct a review of the current literature to determine and evaluate the current classification metrics available for quantifying post-operative dysphagia.

Methods

We surveyed the literature for the subjective and objective measures used to classify dysphagia, and further described and analyzed them in the context of post-operative dysphagia (PD) after anterior cervical spine surgery, with a focus on anterior cervical discectomy and fusion (ACDF). We searched PubMed from the years 2005–2021 using the terms “anterior cervical discectomy and fusion” and “dysphagia or postoperative dysphagia.” We included papers that were meta-analyses, systemic reviews, prospective, or retrospective studies. Our selection was further consolidated via abstract and title screening. Ultimately, nineteen articles were included and had full-text reviews.

Results

EAT-10 tool was shown to be more valid and reliable than the commonly used Bazaz grading system. HSS-DDI was found to have a high diagnostic accuracy in stratifying mild, moderate, and severe PD. A shortened 16-item version of the original 44-item SWAL-QOL was found to be statistically and clinically significant. When compared to PROMs, objective tests more accurately diagnose PD.

Conclusion

We found that the most valuable subjective tests were the EAT-10 and HSS-DI because they are quick, sensitive, and correlated strongly with the well-established measurements of PD. The MBS and FEES provided accurate measurements of the severity of PD, but they required more time and equipment than the surveys. In some patient populations, such as those with pre-surgical dysphagia, objective testing should always be done.
Literature
1.
Ebot J, Domingo R, Nottmeier E (2020) Post-operative dysphagia in patients undergoing a four level anterior cervical discectomy and fusion (ACDF). J Clin Neurosci 72:211–213CrossRefPubMed
2.
3.
Fountas KN et al. (2007) Anterior cervical discectomy and fusion associated complications Spine (Phila Pa 1976). 32(21): 2310–7.
4.
Huang C et al. Comparison of Patient-Reported Postoperative Dysphagia in Patients Undergoing One-Level Versus Two-Level Anterior Cervical Discectomy and Fusion with the Zero-P Implant System. Dysphagia, 2021.
5.
Oh LJ et al (2020) Dysphagia rates in single- and multiple-level anterior cervical discectomy and fusion surgery: a meta-analysis. J Spine Surg 6(3):581–590CrossRefPubMedPubMedCentral
6.
Opsenak R et al (2019) Dysphagia after anterior cervical discectomy and interbody fusion—prospective study with 1-year follow-up. Rozhl Chir 98(3):115–120PubMed
7.
Park JH et al (2020) Analysis of postoperative dysphagia after anterior cervical decompression and fusion. Br J Neurosurg 34(4):457–462CrossRefPubMed
8.
Vaishnav AS et al. Predictive factors of postoperative dysphagia in single-level anterior cervical discectomy and fusion. Spine (Phila Pa 1976), 2019. 44(7): E400–E407.
9.
Li Z et al (2017) A comparison of a new zero-profile, stand-alone Fidji cervical cage and anterior cervical plate for single and multilevel ACDF: a minimum 2-year follow-up study. Eur Spine J 26(4):1129–1139CrossRefPubMed
10.
Aguilar DD et al (2019) Exclusion criteria for dysphagia for outpatient single-level anterior cervical discectomy and fusion using inpatient data from a spine registry. Clin Neurol Neurosurg 180:28–33CrossRefPubMed
11.
Marx RG, Wilson SM, Swiontkowski MF (2015) Updating the assignment of levels of evidence. J Bone Joint Surg Am 97(1):1–2CrossRefPubMed
12.
Rosenthal BD et al (2019) A comparison of patient-centered outcome measures to evaluate dysphagia and dysphonia after anterior cervical discectomy and fusion. J Am Acad Orthop Surg 27(22):848–853CrossRefPubMed
13.
Liu JM et al (2017) The incidences and risk factors related to early dysphagia after anterior cervical spine surgery: a prospective study. PLoS ONE 12(3):e0173364CrossRefPubMedPubMedCentral
14.
Skeppholm M et al. The Dysphagia Short Questionnaire: an instrument for evaluation of dysphagia: a validation study with 12 months' follow-up after anterior cervical spine surgery. Spine (Phila Pa 1976), 2012. 37(11): 996–1002.
15.
Liang G et al. (2021) Comparison of bazaz scale, dysphagia short questionnaire, and hospital for special surgery-dysphagia and dysphonia inventory for assessing dysphagia symptoms after anterior cervical spine surgery in chinese population. Dysphagia.
16.
Cheney DM et al (2015) The ability of the 10-item eating assessment tool (EAT-10) to predict aspiration risk in persons with dysphagia. Ann Otol Rhinol Laryngol 124(5):351–354CrossRefPubMed
17.
Belafsky PC et al (2008) Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 117(12):919–924CrossRefPubMed
18.
Ohba T et al (2020) Risk factors and assessment using an endoscopic scoring system for early and persistent dysphagia after anterior cervical decompression and fusion surgery. Clin Spine Surg 33(4):E168-e173CrossRefPubMed
19.
Rosenthal BD et al (2016) Dysphagia and dysphonia assessment tools after anterior cervical spine surgery. Clin Spine Surg 29(9):363–367CrossRefPubMed
20.
Cordier R et al (2018) Using Rasch analysis to evaluate the reliability and validity of the swallowing quality of life questionnaire: an item response theory approach. Dysphagia 33(4):441–456CrossRefPubMed
21.
22.
Okano I et al (2020) Minimum clinically important differences of the hospital for special surgery dysphagia and dysphonia inventory and other dysphagia measurements in patients undergoing ACDF. Clin Orthop Relat Res 478(10):2309–2320CrossRefPubMedPubMedCentral
23.
Hughes AP et al (2018) HSS Dysphagia and Dysphonia Inventory (HSS-DDI) following anterior cervical fusion: patient-derived, validated, condition-specific patient-reported outcome measure outperforms existing indices. J Bone Joint Surg Am 100(10):e66CrossRefPubMed
24.
Nordin NA, Miles A, Allen J (2017) Measuring competency development in objective evaluation of videofluoroscopic swallowing studies. Dysphagia 32(3):427–436CrossRefPubMed
25.
Hawkins D et al. Dysphagia Evaluation: The Added Value of Concurrent MBS and Esophagram. Laryngoscope, 2021.
26.
Watts S et al (2019) Improving the diagnostic capability of the modified barium swallow study through standardization of an Esophageal sweep protocol. Dysphagia 34(1):34–42CrossRefPubMed
27.
Hiss SG, Postma GN (2003) Fiberoptic endoscopic evaluation of swallowing. Laryngoscope 113(8):1386–1393CrossRefPubMed
28.
Giraldo-Cadavid LF et al (2017) Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia. Laryngoscope 127(9):2002–2010CrossRefPubMed
29.
Erwood MS et al (2019) Assessment of the reliability of the fiberoptic endoscopic evaluation of swallowing as an outcome measure in patients undergoing revision anterior cervical discectomy and fusion. World Neurosurg 130:e199–e205CrossRefPubMed
30.
Yew AY et al. Quantitative risk factor analysis of postoperative dysphagia after anterior cervical discectomy and fusion (ACDF) Using the Eating Assessment Tool-10 (EAT-10). Spine (Phila Pa 1976), 2019. 44(2): E82–e88.
31.
Liu J et al (2018) Risk factors and preventative measures of early and persistent dysphagia after anterior cervical spine surgery: a systematic review. Eur Spine J 27(6):1209–1218CrossRefPubMed
32.
Scholz M et al (2020) Two-level ACDF with a zero-profile stand-alone spacer compared to conventional plating: a prospective randomized single-center study. Eur Spine J 29(11):2814–2822CrossRefPubMed
33.
Riley LH, 3rd et al. Postoperative dysphagia in anterior cervical spine surgery. Spine (Phila Pa 1976), 2010. 35(9 Suppl): S76–85.
34.
Deng Y et al (2020) An absorbable collagen biomembrane help improve swallowing function after anterior cervical spine surgery. Dysphagia 35(5):780–786CrossRefPubMed
35.
Huang CY et al (2020) The effect of the difference in C(2–7) angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the zero-P implant system. BMC Musculoskelet Disord 21(1):649CrossRefPubMedPubMedCentral
36.
Koreckij TD et al. Retropharyngeal steroids and dysphagia following multilevel anterior cervical surgery. Spine (Phila Pa 1976), 2016. 41(9): E530–4.
37.
Kang SH et al (2016) Swallowing function defined by videofluoroscopic swallowing studies after anterior cervical discectomy and fusion: a prospective study. J Korean Med Sci 31(12):2020–2025CrossRefPubMedPubMedCentral
38.
Chen AY et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg, 2001. 127(7): 870–6.
39.
40.
Brady S, Donzelli J (2013) The modified barium swallow and the functional endoscopic evaluation of swallowing. Otolaryngol Clin North Am 46(6):1009–1022CrossRefPubMed
41.
Ding R, Logemann JA (2008) Patient self-perceptions of swallowing difficulties as compared to expert ratings of videofluorographic studies. Folia Phoniatr Logop 60(3):142–150CrossRefPubMed
Metadata
Title
Evaluation of outcome measures for post-operative dysphagia after anterior cervical discectomy and fusion
Authors
Wasef Nijim
J. Harrison Cowart
Christopher Banerjee
Gregory Postma
Michel Paré
Publication date
17-08-2023
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 11/2023
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-08167-7

Other articles of this Issue 11/2023

European Archives of Oto-Rhino-Laryngology 11/2023 Go to the issue

Head and Neck

Risk factors and prognostic models of lymph node metastatic hypopharyngeal squamous cell carcinoma

Head and Neck

A deep learning MRI-based signature may provide risk-stratification strategies for nasopharyngeal carcinoma

Otology

EAONO/JOS classification for acquired cholesteatoma: evaluating the impact of the number of affected sites on treatment and outcomes

Head and Neck

Transoral removal of submandibular hilar lithiasis: results on the salivary duct system, glandular parenchyma, and quality-of-life recovery

Otology

Digital teaching and assessment of psychomotor skills of the clinical head and neck examination during COVID-19 pandemic

Rhinology

Clinical features of chronic fungal rhinosinusitis in Korean geriatric and non-geriatric patients