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Swallowing and laryngeal complications in lung and heart transplantation: Etiologies and diagnosis

https://doi.org/10.1016/j.healun.2021.08.006Get rights and content
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Despite continued surgical advancements in the field of cardiothoracic transplantation, post-operative complications remain a burden for the patient and the multidisciplinary team. Lesser-known complications including swallowing disorders (dysphagia), and voice disorders (dysphonia), are now being reported. Such disorders are known to be associated with increased morbidity and mortality in other medical populations, however their etiology amongst the heart and lung transplant populations has received little attention in the literature. This paper explores the potential mechanisms of oropharyngeal dysphagia and dysphonia following transplantation and discusses optimal modalities of diagnostic evaluation and management. A greater understanding of the implications of swallowing and laryngeal dysfunction in the heart and lung transplant populations is important to expedite early diagnosis and management in order to optimize patient outcomes, minimize allograft injury and improve quality of life.

Keywords

swallowing
laryngeal
voice
dysphagia
dysphonia

Abbreviations

FEES
flexible endoscopic evaluation of swallowing
ICUAW
intensive care unit acquired weakness
LD
laryngopharyngeal dysfunction
LPR
laryngopharyngeal reflux
OPD
oropharyngeal dysphagia
PED
post extubation dysphagia
PPI
proton pump inhibitor
RLN
recurrent laryngeal nerve
SLP
speech language pathologist/pathology
VAD
ventricular assist device
VFP
vocal fold palsy/paresis
VFSS
videofluoroscopic swallow study.

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