EVALUATION OF THE EFFECTIVENESS OF TREATING DYSPHAGIA WITH PHARYNGEAL SENSORY IMPAIRMENT USING THERMAL-TACTILE ORAL STIMULATION (TTOS) AT THE NATIONAL REHABILITATION HOSPITAL

Tóm tắt

Objectives: To evaluate the effectiveness of Thermal-Tactile Oral Stimulation (TTOS) combined with Neuromuscular Electrical Stimulation (NMES) compared to NMES alone in patients with severe dysphagia and pharyngeal sensory impairment. Materials and Methods: A controlled clinical intervention study was conducted on 50 patients with severe dysphagia (Fiberoptic Endoscopic Dysphagia Severity Scale - FEDSS ≥ 5) and pharyngeal sensory loss at the National Rehabilitation Hospital from March 2025 to October 2025. Patients were divided into two groups based on logistical feasibility: The Control Group (n=25) received NMES alone, and the Intervention Group (n=25) received NMES combined with TTOS. Outcomes were assessed after 3 weeks using Fiberoptic Endoscopic Evaluation of Swallowing (FEES) focusing on the Penetration-Aspiration Scale (PAS), FEDSS, Pharyngeal Residue, and Functional Oral Intake Scale (FOIS). Results: Baseline clinical characteristics were similar between groups (p>0.05). After 3 weeks, the Intervention Group showed statistically significant improvement compared to the Control Group. The rate of patients with no pharyngeal residue (Level 0) was 36% in the Intervention Group vs. 12% in the Control Group (p=0.037). PAS scores for liquids were significantly lower in the Intervention Group (3.64±2.46 vs. 5.32±1.88; p=0.022), as were PAS scores for semi-solids (2.56±2.29 vs. 3.64±2.27; p=0.033). The FEDSS score decreased significantly to 3.88±1.16 compared to 4.72±1.14 in the control group (p=0.010). Notably, the rate of total oral intake (FOIS > 3) in the intervention group reached 60% compared to 28% in the control group (p=0.037). Conclusion: The combination of TTOS and NMES is significantly more effective than NMES alone for treating severe dysphagia with pharyngeal sensory loss, leading to improved swallowing safety, reduced residue, and higher rates of return to oral intake.