Table 3.
Case series patient demographics and swallowing dysfunction
| Case no | Gender | Age | Type of sarcoid | Endoscopic surgical interventions | SLT intervention | FOIS pre-op | FOIS post-op | Pre-op VFS | Pre-op FEES | Post-op VFS | Post-op FEES |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | F | 56 | Systemic—nasal and laryngeal | × 2 | Food textures, voice and reflux advice | 7 | 6 | Incomplete epiglottic deflection, reduced laryngeal elevation, penetration and aspiration during the swallow. PAS 6 | No | No | Scarred and stiff epiglottis, reduced adduction of vocal cords, reduced tongue base retraction and epiglottic deflection, spontaneous clearance of penetration. PAS 2, RS 1 |
| 2 | M | 45 | Systemic—nasal, laryngeal and suspected neuro | × 2 | Assessment only | 7 | No | No | Variable swallow trigger. PAS 1 | No | |
| 3 | F | 35 | Laryngeal | × 3 | Safe eating strategies | 5 | No | Reduced tongue base retraction and pharyngeal squeeze, penetration during and post-swallow. PAS 3, RS 2 | No | No | |
| 4 | F | 34 | Systemic—pulmonary and laryngeal | × 3 | Safe eating strategies, chronic cough and hypersensitivity therapy including reflux management | 5 | No | Very bulky arytenoids with minimal pyriform space. Hypersensitivity. Penetration and aspiration during and post-swallow. PAS 8, RS 0 | No | No | |
| 5 | F | 54 | Systemic—pulmonary, nasal and laryngeal | × 1 | No swallow therapy as patient wished to focus on voice therapy only | 6 | 5 | No | No | No | Delayed swallow trigger, reduced pharyngeal squeeze, penetration during swallow PAS 5, RS 1 |
| 6 | M | 22 | Laryngeal | × 1 | Pre-op advice. Post-op swallow therapy exercises – Effortful and Masako | 7 | 7 | No | Delayed swallow trigger, nil epiglottic deflection, reduced pharyngeal squeeze, penetration and aspiration during swallow. PAS 8, RS 1 | No | Less oedema of supraglottic structures, nil epiglottic deflection, penetration during and post-swallow. PAS 5, RS 2 |
| 7 | F | 70 | Systemic—pulmonary and laryngeal | 0* |
2 × periods of voice and swallow therapy 2016—Masako, Shaker and Effortful swallow exercises 2018—6 weeks of further swallow therapy |
5 | No | No | Delayed swallow trigger, significantly reduced pharyngeal squeeze, reduced hyolaryngeal excursion and reduced cricopharyngeal opening, with diffuse residue, penetration during swallow. PAS 4 | No |
PAS Penetration-Aspiration Scale, RS Residue Score
*Patient had multiple in-office vocal cord augmentation injections but no dilatation