A systematic review of dysphagia prevalence and the role of Otolaryngologists in high-grade glioma management

ABSTRACT Background and Objectives: Gliomas are the most common primary malignant brain tumors in adults, with high-grade gliomas (HGG, World Health Organization grades III and IV) being highly infiltrative and carrying a poor prognosis. Dysphagia, affecting 8%–79% of HGG patients, is a common and complex symptom often leading to severe complications, including death. Effective management can improve quality of life (QoL). This systematic review examines the prevalence, symptoms, airway complications, and interventions in glioma patients, highlighting otolaryngologists’ role in palliative care and improving QoL. Methods: We conducted a comprehensive search of PubMed and Google Scholar for studies published between 2014 and 2024, using a combination of relevant subject headings and keywords. Studies were selected based on predefined inclusion and exclusion criteria. The primary outcome was the prevalence of dysphagia in HGG patients. Secondary outcomes included symptoms requiring otolaryngologic intervention, and therapeutic approaches for these patients. Results: The search identified 9239 studies, with 9234 remaining after duplicate removal. Following title and abstract screening, 9087 studies were excluded for not meeting criteria. Of the 147 articles assessed for eligibility, six cohort studies were included in the review. Dysphagia prevalence in glioma patients ranged from 8% to 79%, increasing significantly near end-of-life (EOL). Respiratory complications, often secondary to dysphagia, similarly trended upward near the EOL. None of the studies reported otolaryngologist involvement in patient management. Conclusion: Dysphagia commonly affects glioma patients during EOL, yet otolaryngologist involvement in managing airway complications is rarely documented. A multidisciplinary approach including otolaryngologists may improve patient QoL.