Fiberoptic endoscopic evaluation of swallowing in amyotrophic lateral sclerosis: comparison with older people with dysphagia and relationship with time since diagnosis.

purpose(1) to compare the findings of the instrumental swallowing assessment between individuals with amyotrophic lateral sclerosis (ALS) and older dysphagic adults without neurological diagnosis; (2) to compare the onset of pharyngeal response, pharyngeal residues, and the level of oral intake in relation to the time since diagnosis in the ALS group.

methodsThis cross-sectional, retrospective study collected data from medical records. Altogether, 101 individuals with dysphagia were included and stratified into two groups: the first had 56 patients diagnosed with ALS, and the second had 45 older adults. Dysphagia signs were analyzed through fiberoptic endoscopic evaluation of swallowing, using four food consistencies, classified by the International Dysphagia Diet Standardisation Initiative (IDDSI). Pharyngeal residues were classified by the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), and oral intake by the Functional Oral Intake Scale (FOIS).

resultsThe ALS group had differences in multiple swallows with one IDDSI consistency; posterior oral leakage, pharyngeal residues, and laryngeal penetration with three consistencies; and aspiration with one consistency. Individuals with more than 3 years since diagnosis had differences in the onset of the pharyngeal response in the pyriform sinuses, moderate pharyngeal residues, and oral intake.

conclusionThe ALS group had significant differences in the occurrence of multiple swallows, posterior oral leakage, pharyngeal residues, penetration, and aspiration with three IDDSI consistencies. Furthermore, the time since diagnosis was a determining factor for all three parameters.