Co-manifestation of swallowing dysfunction indicators and vocal fold motion impairment within a shared neural substrate in patients with brain injury: a cross-sectional study
Abstract
Background Vocal fold motion impairment (VFMI) is a common but frequently overlooked complication in patients with brain injury and can significantly compromise multiple airway protective functions—including glottic closure during swallowing, cough reflex, and cough effectiveness—leading to increased risks of aspiration, pneumonia, and poor clinical outcomes. Although swallowing dysfunction and VFMI often coexist in patients with brain injury, the specific characteristics and underlying mechanisms of their association have not been systematically investigated. Methods This single-center cross-sectional study consecutively enrolled 280 patients with brain injury from June 2024 to May 2025. All patients underwent fiberoptic endoscopic evaluation of swallowing (FEES) to simultaneously assess 18 swallowing indicators covering 5 dimensions and vocal fold motor function. VFMI was defined as complete fixation or hypomotility of the vocal folds under endoscopy. Multivariable logistic regression analysis identified swallowing indicators that significantly co-occurred with VFMI after adjusting for potential confounders. To address the extreme collinearity between bilateral pyriform sinus secretion variables (Spearman r = 0.974), a composite maximum-score variable [PS_MAX = max(left, right)] was constructed. Results Among 280 patients, 220 (78.6%) had VFMI. After adjusting for confounders, restricted pharyngeal wall movement (OR = 2.16, 95% CI: 1.06–4.38, p = 0.034) and pyriform sinus…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 280 participants or records.
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