Dr Nicola Clayton1,2,3,4, Dr Rosalba Cross3, Dr Mark Kol3, Prof Peter Maitz1,5
1Burns Unit, Concord Repatriation General Hospital, Concord, Australia, 2Speech Pathology Department, Concord Repatriation General Hospital, Concord , Australia, 3Intensive Care Unit, Concord Repatriation General Hospital, Concord, Australia, 4School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, Brisbane, Australia, 5University of Sydney, Camperdown, Australia
Background: The impact of inhalation burn injury on swallowing and laryngeal function is not well understood. Limited evidence suggests that inhalation injury to the upper aerodigestive tract may be associated with increased risk for dysphagia and dysphonia however the specific features of laryngeal pathology, recovery pattern and non-surgical treatment options has not been documented.
Purpose: To describe the physiological characteristics and pattern of recovery of swallowing and laryngeal pathology following inhalation thermal burn injury.
Methods: All patients admitted with thermal burn injury, including a suspected inhalation component, between 2008 and 2017 inclusive were reviewed for inclusion within the study. Those diagnosed with dysphagia and laryngeal pathology formed the final cohort. Demographic, burn and critical care data were collected in addition to swallowing, voice and laryngeal outcome measures from the point of admission through to discharge.
Results & Conclusions: Preliminary data suggests that while these patients often recover swallowing ability during their acute care admission, longer term laryngeal pathology affecting airway and vocal function may be experienced. Key features of dysphagia include both motor and sensory aspects to swallowing dysfunction with onset evident early in the acute admission. Laryngeal pathology however, is an evolving process, potentially compounded by medical and demographic factors, with late evidence of scar tissue and contracture. Specific physiological characteristics and treatment regimes are explored in this highly challenging population, with early identification of pathology associated with better patient outcomes.
Nicola is a clinical specialist speech pathologist at Concord Repatriation General Hospital. She is recognised nationally and internationally for her clinical expertise and research in the assessment and treatment of complex swallowing disorders following severe burn injury and completed her PhD in this area.