Dysphagia in post-carotid endarterectomy: a prospective study

Area of Science:

• Otolaryngology
• Neurology
• Gastroenterology

Background:

• Dysphagia is a frequent and disabling complication following carotid endarterectomy.
• Management strategies for post-operative swallowing difficulties require further investigation.

Purpose of the Study:

• To evaluate the effectiveness of early swallowing assessment and rehabilitation in patients experiencing dysphagia after carotid endarterectomy.

Main Methods:

• A prospective cohort of 19 patients with post-carotid endarterectomy dysphagia was studied.
• Swallowing function was assessed using bedside evaluation and fiberoptic endoscopic evaluation of swallowing (FEES) at 5 days and 3 months.
• The Penetration-Aspiration Scale (PAS) was used to quantify dysphagia severity; early rehabilitation was initiated for all participants.

Main Results:

• At baseline, 15 patients had dysphagia for both liquids and solids, and six showed bronchial aspiration.
• Within 3 months, 16 patients recovered swallowing function and resumed their preoperative diet.
• No pneumonia occurred, and bronchial aspiration was minimal at 3-month follow-up (mean PAS score decreased from 5.2 to 1.2).

Conclusions:

• Careful swallowing evaluation and prompt rehabilitation are crucial for managing dysphagia post-carotid endarterectomy.
• This approach appears effective in improving swallowing function and preventing complications like pneumonia.