Speech pathologist practice patterns for evaluation and management of suspected cricopharyngeal dysfunction

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Swallowing Disorders

Background:

• Cricopharyngeal (CP) dysfunction diagnosis and management are primarily handled by speech pathologists.
• Current clinical practices for CP dysfunction interventions lack standardization.
• Understanding current management trends is crucial for developing evidence-based guidelines.

Purpose of the Study:

• To investigate the current management strategies and interventions used by speech pathologists for patients with suspected cricopharyngeal dysfunction.
• To identify variations in recommended approaches based on patient pharyngeal strength and available diagnostic tools.

Main Methods:

• A paper-based survey was distributed to 206 members of the American Speech-Language Hearing Association's Special Interest Group 13.
• The survey presented two clinical cases of suspected CP dysfunction (with and without pharyngeal weakness).
• Respondents ranked management approaches and selected specific interventions for each case.

Main Results:

• The majority of speech pathologists recommended swallowing therapy as the initial approach for both cases (64% for Case 1, 88% for Case 2).
• Commonly recommended exercises included the Shaker, effortful swallow, and Mendelsohn maneuver.
• Referral rates varied significantly (76% for Case 1, 38% for Case 2), and access to evaluative tools influenced recommendations for further assessment.

Conclusions:

• Significant variability exists in the management of cricopharyngeal dysfunction among speech pathologists.
• The findings underscore the urgent need for standardized best practice guidelines to ensure consistent and effective patient care.
• Further research into optimal diagnostic and therapeutic pathways for CP dysfunction is warranted.