Influence of Inhalation Injury on Incidence, Clinical Profile and Recovery Pattern of Dysphagia Following Burn Injury

• Published in: Dysphagia 2020-12, Vol.35 (6), p.968-977
• Main Authors: Clayton, N. A., Ward, E. C., Rumbach, A. F., Cross, R. R., Kol, M. R., Maitz, P. K.
• Format: Article
• Language: English
• Subjects: Burn patients; Burns; Burns and scalds; Comparative analysis; Deglutition disorders; Dysphagia; Enteral feeding; Gastroenterology; Head and neck; Hepatology; Imaging; Inhalation; Language; Laryngoscopy; Mechanical ventilation; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Original; Original Article; Ostomy; Otorhinolaryngology; Pathology; Pharynx; Radiology; Recovery (Medical); Smoke inhalation; Speech; Speech therapy; Tracheostomy
• ISSN: 0179-051X; 1432-0460
• DOI: 10.1007/s00455-020-10098-y

Inhalation injury is predictive of dysphagia post burns; however, the nature of dysphagia associated with inhalation burns is not well understood. This study describes the clinical profile and recovery pattern of swallowing following inhalation burn injury. All patients admitted 2008–2017 with confirmed inhalation burns on laryngoscopy and managed by speech-language pathology (SLP) were included. Initial dysphagia presentation and dysphagia recovery pattern were documented using the FOIS. Co-presence of dysphonia was determined clinically and rated present/absent. Persistent laryngeal/pharyngeal injury at 6 months was documented using laryngoscopy. Data were compared to published data from a large adult burn cohort. All patients with confirmed inhalation burns during the study period received SLP input, enabling review of 38 patients (68% male; m  = 40.8 years). Percent Total Body Surface Area burn ranged 1–90%, 100% had head and neck burns, 97% required mechanical ventilation (mean 9.4 days), 18% required tracheostomy and 100% had dysphonia. Comparing to non-inhalation burn patients, the inhalation cohort had significantly ( p