Charting the recovery of dysphagia in two complex cases of post-thermal burn injury: Physiological characteristics and functional outcomes

2 Charting the recovery of dysphagia in two complex cases of post-thermal burn injury: Physiological characteristics and functional outcomes 3 Abstract Purpose: The current study examined the physiological deficits, recovery pattern and outcomes observed clinically and instrumentally in two participants with dysphagia post thermal burn. Methods: Participants were followed prospectively using clinical and instrumental tools of assessment until dysphagia recovery. Clinical swallowing examinations were carried out every 1 to 2 days, or as clinically indicated. Instrumental assessment using fiberoptic endoscopic examination of swallowing was carried out at fortnightly intervals. Results: Despite variability in the achievement of oral intake milestones, both cases demonstrated protracted recovery from dysphagia contributed to by medical instability and lengthy periods of ventilation and intubation. Instrumental assessment confirmed silent aspiration in both participants, likely due to decreased laryngopharyngeal sensation. By discharge, participants had returned to their pre-morbid diets. Conclusions: This study highlights the protracted and complex recovery pattern associated with dysphagia following thermal burn injury. The presence of silent aspiration emphasizes the need for instrumental assessment to objectively assess aspiration risk and to facilitate dysphagia recovery within this population