Cervical Auscultation Validity in the Evaluation of Dysphagia in Elderly Patients
Introduction: Population aging is associated with increased prevalence of dysphagia. Among the tools for the evaluation of oropharyngeal dysphagia is a functional clinical one, involving cervical auscultation. This method analyzes the sounds of swallowing to assess the competence of the pharyngeal phase and its interaction with breathing through the use of a stethoscope.
Objectives: To check the validity of cervical auscultation in the clinical evaluation of oropharyngeal dysphagia in elderly. Data synthesis: Search in the virtual library on health data, using the key words: cervical auscultation, dysphagia, diagnosis, and elderly. It included research studies, English and Portuguese, on the use of cervical auscultation in the elderly. We have found 10 studies. After reading the abstracts, one study was selected. Studies have shown that swallowing has audible cues, allowing auscultation identify patients at risk for aspiration/penetration; however, these signs have peculiarities in the elderly than in the young. The absence of cues audible swallowing does not predict dysphagia, but an abnormal pattern indicates repeated swallowing impairment. It is agreed that the experience of the evaluator influences on test performance, as well as the need for complementary diagnostic methods.
Conclusion: Neck auscultation is an important feature for diagnosis in oropharyngeal dysphagia. It is cheap, easy to perform, and noninvasive, although it is recommended the usage of additional instruments, due to the subjectivity of the method. Specific work with elderly are scarce, thus publications on the topic are necessary due to the high prevalence of dysphagia in this age group.