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The proposed study seeks to determine the incidence of dysphagia and vocal fold mobility impairment (VFMI) in individuals undergoing throacic surgical procedures. It also seeks to determine the impact of postoperative swallowing impairment on health-related outcomes.
Swallowing impairment and VFMI are common, yet often overlooked, complications of thoracic surgical procedures. The true incidence of both dysphagia and VFMI in this patient population is unclear due to a lack of rigorous study using instrumental assessment techniques and validated outcomes in all patents undergoing thoracic surgery. The study is therefore aimed to determine the incidence of dysphagia and VFMI in this patient population and to characterize impairment profiles related to swallowing safety and efficiency. In addition, the study is also aimed to assess the relative impact of VFMI and dysphagia on health-related outcomes such as length of hospital stay, pneumonia, sepsis, reintubation, and discharge status
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Thoracic Surgical Patients | Participants will undergo a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fiberoptic Endoscopic Evaluation of Swallowing | Procedure | This procedure involves inserting a flexible laryngoscope that contains a light source and video camera on the end through the open passage of the nose towards the back of the throat in order to visualize the swallowing mechanism. |
| Measure | Description | Time Frame |
|---|---|---|
| Penetration Aspiration Scale | This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials. The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled. | Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Yale Residue Severity Rating Scale | This scale is a validated measure used by trained blinded clinicians to assign ratings of efficiency to swallowing bolus trials. The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe). |
| Measure | Description | Time Frame |
|---|---|---|
| Vocal Fold Mobility Impairment | During a Fiberoptic Endoscopic Evaluation of Swallowing (FEES), the vocal folds will be visualized using a small camera passed through the open nasal passage. The patient will be asked to make a series of vocal tasks so that we can visualize their movement, any immobility will be notated. | Baseline |
Inclusion Criteria:
Exclusion Criteria:
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240 individuals undergoing thoracic surgery will be enrolled in this study.
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| Name | Affiliation | Role |
|---|---|---|
| Emily K Plowman, PhD | University of Florida | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cardiovascular Clinic at UF Health UF | Gainesville | Florida | 32610 | United States | ||
| Thoracic and Cardiovasscular Surgery at UF Health |
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| ID | Term |
|---|---|
| D013896 | Thoracic Diseases |
| D003680 | Deglutition Disorders |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D005249 | Fees and Charges |
| ID | Term |
|---|---|
| D004467 | Economics |
| D004472 | Health Care Economics and Organizations |
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|
|
| Baseline |
| Gainesville |
| Florida |
| 32610 |
| United States |
| UF Health at the University of Florida | Gainesville | Florida | 32610 | United States |
| D010608 | Pharyngeal Diseases |
| D010038 | Otorhinolaryngologic Diseases |