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Comprehensive Otolaryngology

Geriatric Dysphagia: Perioperative Care and Surgical Patient Selection

Tuesday, October 3, 2023
1:00 PM - 2:00 PM East Coast USA Time
Location: 202A

    Moderator(s)

  • OT

    Ozlem E. Tulunay-Ugur, MD

    Professor, Director Division of Laryngology
    University of Arkansas
    Little Rock, AR, United States

    • Panelist(s)

  • Karen M. Kost, MD, FRCS

    Professor of Otolaryngology-Head and Neck Surgery, Director of the Voice and Dysphagia Laboratory, McGill University
    McGill University Health Center
    Westmount, QC, Canada

  • DE

    David Eibling, MD

    University of Pittsburgh Medical Center, USA

Disclosure(s):
Ozlem E. Tulunay-Ugur, MD: No relevant relationships to disclose.
Karen M. Kost, MD, FRCS: No relevant relationships to disclose.
PROGRAM DESCRIPTION: As medicine improves and longevity increases, clinicians face an imminent need to understand physiological changes of aging. One of the most common aging related disorders is dysphagia. Dysphagia not only has significant quality-of-life implications, but also carries risk of mortality. In this panel, we aim to arm the Otolaryngologist with the necessary tools to assess the geriatric patient with dysphagia. Emphasis will be on surgical technique selection as well as peri-operative care. Geriatric patients, who are not just “old adults” have unique differences from younger adults and require particular knowledge of these variances; as they will determine outcomes. This course is unique in the sense that it will not only discuss surgical options, but pre-operative preparation of the patients, patient optimization and key components to successful early post-operative care of a geriatric patient with dysphagia will be discussed. Prevention of post-operative delirium which is common in this age group will be explained. The close cause and effect relationship between frailty, sarcopenia and dysphagia will be presented as well as strategies for improvement of all three interlinked problems. The role of rehabilitative therapy and dietary needs during the pre and post-operative period will be emphasized.

OUTCOME OBJECTIVE 1: To understand the differences between a younger and an older adult with regards to etiology of dysphagia and pertinent pre-operative work-up for surgical optimization, including how to assess geriatric patients for frailty, sarcopenia.

OUTCOME OBJECTIVE 2: To be able to effectively diagnose and manage causes of dysphagia more commonly seen in the older population, such as Cricopharyngeal dysfunction and Zenker’s diverticulum and leave with a thorough understanding of all surgical techniques and describe pearls and pitfalls of each.

OUTCOME OBJECTIVE 3: To be able to describe optimal peri-operative care of geriatric patients with dysphagia including therapy and nutritional needs, as well as common post-operative problems and preventative measures.

BACKGROUND STATEMENT: Geriatric patients needing dysphagia surgery are increasing, but otolaryngologists offering surgeries remain limited. This is likely due to apprehension about frail patients and surgical complications. This panel aims to discuss not only surgical technique but also patient optimization.