Electrical stimulation of the pharynx for neurogenic dysphagia
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 7 sources, which was discussed by the committee. The evidence included 2 systematic reviews and meta-analyses, 2 randomised controlled trials, 1 registry analysis, and 2 pilot studies. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: improved dysphagia, less need for nasogastric and percutaneous endoscopic gastrostomy or jejunostomy feeding, and less time to tracheostomy decannulation.
3.3 The professional experts and the committee considered the key safety outcomes to be: device-related discomfort and aspiration.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 Most of the evidence reviewed by the committee was from people with stroke. One of the randomised controlled trials in this population showed no benefit of electrical stimulation of the pharynx.
3.6 The committee was informed that the optimal treatment protocol had not been defined.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
September 2022
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