Objective: This study aimed to assess the risk of sarcopenic dysphagia and identify the factors associated with it in community-dwelling older adults. Methods: A total of 186 healthy older adults aged ≥65 years participated in this study. Sarcopenic dysphagia was diagnosed using a diagnostic algorithm. The factors used for assessment were orofacial muscle strength, tongue and masseter thickness, maximum occlusal force, perceived dysphagia severity, oral health-related quality of life, and dental factors. Descriptive statistics, one-way analysis of variance followed by Scheffé’s test, and logistic regression analysis were performed to analyze the factors related to sarcopenic dysphagia. Results: Approximately 46% of healthy older adults in the community were at risk of sarcopenic dysphagia.Sarcopenic dysphagia was associated with reduced orofacial muscle strength, decreased tongue and masseter thickness, decreased bite force, increased perceived dysphagia severity, lower oral health-related quality of life, and reduced oral mucosal moisture. Conclusion Screening of the swallowing function based on factors related to sarcopenic dysphagia and implementing management strategies such as orofacial muscle strengthening and prevention of dry mouth are important for maintenance of the swallowing function.

This case report highlights the effectiveness of Videofluoroscopic Swallowing Study-guided balloon dilation in managing dysphagia resulting from subclinical recurrent laryngeal nerve (RLN) neuropathy after a non-lethal hanging attempt. A 71-year-old male presented with dysphagia following an attempted hanging. The initial assessments revealed neck pain, soft tissue edema, and a fractured hyoid bone. Despite stable respiratory findings, the patient had significant swallowing difficulties. The patient underwent a VFSS that revealed an upper esophageal sphincter (UES) dysfunction linked to bilateral RLN neuropathy. After conventional dysphagia therapy, VFSS-guided balloon dilation was performed on day 46 after a tracheostomy. Following the procedure, significant improvement in swallowing function was noted, with the Penetration–Aspiration Scale (PAS) score decreasing from 5 to 2. The intervention was well-tolerated, with no significant adverse events reported. VFSS-guided balloon dilation is a safe and effective treatment option for dysphagia caused by an impaired UES opening resulting from subclinical RLN neuropathy after hanging. Further studies with larger populations will be needed to validate these findings and refine the treatment protocols.

Dysphagia is a critical clinical condition requiring rehabilitation to prevent complications, including malnutrition and aspiration pneumonia. Telerehabilitation allows patients to receive appropriate rehabilitation at home, regardless of location and time, and reducing costs, presenting a viable alternative to traditional face-to-face intervention.This paper reviews current evidence on telerehabilitation for dysphagia management, focusing on the paradigm shift from evaluation to therapeutic intervention. The review showed that telerehabilitation research has focused mainly on establishing the validity and reliability of remote swallowing evaluations, while studies on therapeutic interventions remain insufficient. Nevertheless, emerging evidence suggests that telerehabilitation can effectively improve swallowing function through therapeutic interventions. Future research should prioritize high-quality randomized controlled trials, compliance-enhancing strategies, standardized telerehabilitation protocols, cost-effectiveness analyses, and specialized training programs for therapists.

Hypopharyngeal cancer is an aggressive malignancy that is often diagnosed at an advanced stage, requiring an extensive surgical resection and complex reconstruction. Although surgery remains a cornerstone of curative management, significant postoperative dysphagia frequently occurs due to anatomical disruption, neuromuscular impairment, and altered physiology of swallowing. Understanding the mechanisms and rehabilitation strategies for dysphagia is essential for optimizing the postoperative function and quality of life. The surgical approaches for hypopharyngeal cancer include partial or total laryngopharyngectomy, depending on the tumor extent and organ preservation feasibility. These procedures inevitably damage the pharyngeal constrictors, laryngeal elevation mechanism, and upper esophageal sphincter opening, leading to impaired bolus transit and a high risk of aspiration. Moreover, loss of sensory innervation and the replacement of native pharyngeal muscle with non-contractile flap tissue further aggravate the swallowing dysfunction. Dysphagia following the surgical treatment of hypopharyngeal cancer arises from multifactorial causes related to the resulting anatomical, neurological, and reconstructive changes. Early assessment, individualized rehabilitation, and coordinated multidisciplinary care are fundamental to restoring safe and efficient swallowing. Future research should focus on improving reconstructive techniques and developing evidence-based rehabilitation protocols to enhance the postoperative quality of life.

Objective: To analyze dysphagia assessment tools for dementia patients using the International Classification of Functioning, Disability and Health (ICF) framework and suggest future clinical directions. Methods: A scoping review of literature published between 2015 and 2025 identified 44 studies. Thirty assessment tools were mapped to the four ICF components: Body functions, activities, participation, and environmental factors. Results: Instrumental assessments (Videofluoroscopic Swallowing Study [VFSS], Fiberoptic Endoscopic Evaluation of Swallowing [FEES]) and the Water Swallow Test were most frequently used. ICF mapping revealed that 96.7% of tools focused on body functions, while only approximately 20% addressed participation and environmental factors.Self/caregiver-report questionnaires covered multidimensional domains but were limited by subjectivity, whereas instrumental assessments were objective but restricted to body functions. Conclusion Current assessments prioritize physiological safety, often overlooking actual eating activities and environmental contexts. Future research should focus on developing ICF-based standardized observational tools to objectively assess eating behaviors, environmental factors, and body functions. This approach will support occupational therapist-led integrated rehabilitation to improve the quality of life of patients.

The oral phase is the critical initial stage of swallowing, where the oral motor function is essential. Oral phase impairment can lead to severe complications such as malnutrition and pneumonia. Therefore, accurate assessments are clinically critical. This study systematically reviewed the characteristics and measurement elements of assessment tools for evaluating the oral function and oral motor function in adult dysphagia patients. A systematic literature search was conducted using PubMed, CINAHL, Google Scholar, and RISS databases for articles published up to June 2025.Ultimately, 43 articles were selected, and 22 standardized assessment tools identified within these studies were analyzed.The assessments were classified into standardized clinical tools (n=22) and instrument-based methods. An analysis of the standardized tools revealed a frequent focus on static measures like ‘Anterior spillage’ (54.5%) and ‘mealtime duration’ (45.5%), while dynamic aspects like ‘tongue propulsion’ (9.1%) were overlooked. The instrument-based methods, including oral diadochokinesis, chewing gum tests, and tongue pressure measurement, had the advantage of quantitatively evaluating the oral function. The results showed that an integrated and standardized assessment protocol capable of deeply evaluating the oral phase is needed. This study provides foundational data for the evidence-based application of oral phase assessments in future clinical practice and research.

Jugular foramen syndrome (JFS) results from a dysfunction of the lower cranial nerves (CN IX–XII) traversing the jugular foramen and presents with diverse clinical manifestations depending on the nerves involved. Surgical resection is the primary treatment for benign jugular foramen tumors, but postoperative neurological deterioration remains a significant concern. This paper reports a case of worsened dysphagia following the surgical treatment of JFS despite anatomical preservation of the lower cranial nerves. A 68-year-old man presented with long-standing left-sided hearing loss, tongue atrophy, and a recent onset of dysphagia. Imaging revealed a left jugular foramen mass that was initially suspected of being a schwannoma. The patient underwent tumor removal via a combined transcochlear and transcervical approach, with intraoperative preservation of CN IX–XII. Histopathology confirmed paraganglioma. Postoperatively, the patient experienced aggravated dysphagia, with video fluoroscopic swallowing studies showing persistent residue in the left pyriform sinus. Although the subjective swallowing function gradually improved, the neurological deficits did not fully recover. This case shows that even when a preexisting cranial nerve dysfunction is present and the nerves are preserved intraoperatively, the swallowing function can deteriorate after surgery. Therefore, a thorough preoperative functional assessment and careful consideration of potential postoperative functional decline are essential in the surgical management of jugular foramen tumors.

Foix-Chavany-Marie syndrome (FCMS), or bilateral anterior opercular syndrome, is a rare form of pseudobulbar palsy characterized by an automatic-voluntary dissociation of the facio-pharyngo-glosso-masticatory muscles. Although dysphagia is a major clinical feature of FCMS, few studies have described its longitudinal progression, particularly in the context of epileptic encephalopathy. This paper reports a 32-year-old male with long-standing Lennox-Gastaut syndrome secondary to childhood herpes simplex encephalitis who developed FCMS with rapidly progressive dysphagia. Brain magnetic resonance imaging revealed multifocal old infarcts involving the bilateral frontoparietal opercular regions on a background of chronic encephalomalacia. Clinically, the patient exhibited classic automatic-voluntary dissociation. Serial videofluoroscopic swallowing studies (VFSS) over two months revealed rapid deterioration, from selective penetration with preserved semisolid swallowing to universal silent aspiration across all consistencies. Unlike typical FCMS caused by acute bilateral ischemic stroke, this case suggests a cumulative, epileptic network-mediated mechanism. The VFSS findings support a functional decompensation model, in which exhaustion of the swallowing network reserve may lead to abrupt functional collapse without radiologic evidence of a new structural lesion. Serial VFSS provides critical functional insight into the disease progression in FCMS and may guide appropriate decisions regarding long-term enteral nutrition.

Objective: To clarify the dose–response relationships of neuromuscular electrical stimulation (NMES) for post-stroke dysphagia and identify the optimal protocols. Methods: A systematic review and dose–response meta-analysis of randomized controlled trials (RCTs) was conducted under the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 (PROSPERO:CRD420251126373). Twenty-four RCTs with 1,125 stroke patients were included. Primary outcomes evaluated swallowing safety using Penetration–Aspiration Scale (PAS), hyoid movement, Functional Oral Intake Scale (FOIS), and Water Swallow Test (WST). Linear and nonlinear meta-regression were used to assess NMES parameters (dose, duration, onset timing). Results: A higher cumulative NMES dose was linearly associated with improved PAS, suggesting that ≥15 hours of stimulation may be required for meaningful airway protection. Earlier initiation yielded greater hyoid improvements, consistent with the principles of neuroplasticity recovery. Non-linear analyses showed U-shaped dose–response curves for hyoid excursion and the WST, with more potent effects at lower and higher doses. FOIS showed no consistent associations. Adverse events were rare and mild (skin irritation). Conclusion The efficacy of NMES for post-stroke dysphagia depends on the stimulation dose, timing, and duration.Individualized protocols should align with therapeutic goals, while larger trials are needed to refine practice and inform policy.

Objective: This study examined the comparative effects of expiratory muscle strength training (EMST) and combined respiratory muscle strength training (RMST) on the swallowing function and quality of life of patients with Parkinson’s disease. Methods: Thirty-two participants were assigned randomly to the EMST or RMST groups and completed a six-week training protocol. Both groups showed significant improvements in the penetration aspiration scale (PAS), post-swallow vallecular residue, and the total Korean swallowing-quality of life questionnaire (K-SWAL-QOL) scores (P＜0.05). Results: The EMST group showed greater gains in the peak cough flow and meal-related satisfaction, whereas the RMST group showed reduced saliva frequency and improved pharyngeal residue clearance. Correlation analyses revealed significant associations indicating a linkage between the improvement of respiratory and swallowing function. Conclusion Despite the lower intensity of the flow-dependent RMST device, the swallowing outcomes were comparable to those of the high-intensity EMST group, suggesting that combined inspiratory-expiratory training may provide similar benefits with a lower physiological demand. These findings support RMST as a feasible and clinically meaningful intervention for dysphagia management in Parkinson’s disease, in addition to EMST.