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

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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.

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Acknowledgements

There are no acknowledgements. The authors declare that there is no conflict of interest, and no funding sources were used.

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The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Medical College of Georgia, Augusta, GA, USA

    Wasef Nijim

  2. Department of Neurosurgery, Emory University Hospital, Atlanta, GA, USA

    J. Harrison Cowart & Christopher Banerjee

  3. Department of Otolaryngology, Medical College of Georgia, Augusta, GA, USA

    Gregory Postma

  4. Department of Neurosurgery, Medical College of Georgia, Augusta, GA, USA

    Michel Paré

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  1. Wasef Nijim
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  2. J. Harrison Cowart
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  3. Christopher Banerjee
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  4. Gregory Postma
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Contributions

WN: review of articles, writing of first draft, revisions and edits of following drafts. HC: review of articles, writing of first draft, revisions and edits of following drafts. CB: conception of project, revisions and edits of manuscript. GP: revisions and edits of manuscript. MP: revisions and edits of manuscript.

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Correspondence to Wasef Nijim.

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Nijim, W., Cowart, J.H., Banerjee, C. et al. Evaluation of outcome measures for post-operative dysphagia after anterior cervical discectomy and fusion. Eur Arch Otorhinolaryngol 280, 4793–4801 (2023). https://doi.org/10.1007/s00405-023-08167-7

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  • DOI: https://doi.org/10.1007/s00405-023-08167-7

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