ABSTRACT NUMBER: ESOC2026A540 ENHANCING POST-STROKE EXTUBATION SWALLOWING RECOVERY WITH PHARYNGEAL ELECTRICAL STIMULATION: EVIDENCE FROM A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Abstract Background and aims Post-stroke dysphagia is associated with aspiration, prolonged hospitalization, and poor recovery. Pharyngeal electrical stimulation (PES) is an emerging neurostimulation technique designed to enhance swallowing function through modulation of pharyngeal sensory pathways. This study aimed to systematically review and meta-analyze the effects of PES on swallowing outcomes and safety in patients with acute stroke. Methods We performed a systematic review and meta-analysis of randomized controlled trials evaluating PES in patients with post-stroke dysphagia. PubMed, Scopus, and Web of Science were searched from inception to December 2025. Outcomes included dysphagia severity, swallowing function, functional oral intake, feeding tube withdrawal, length of stay, and safety. Results Nine randomized controlled trials involving 448 patients were included. PES significantly improved overall swallowing function compared with control (SMD = −0.30, 95% CI: −0.50 to −0.10), with dysphagia severity scores also showing greater improvement (SMD = −0.35, 95% CI: −0.55 to −0.15). Patients receiving PES had higher rates of nasogastric tube withdrawal (RR = 2.5, 95% CI: 1.8–3.5) and improved functional oral intake. The analysis demonstrated a significant reduction in hospital length of stay, driven largely by post-extubation stroke populations (SMD = −0.5, 95% CI: −0.80 to −0.20). PES was well tolerated, with no increase in serious adverse events. Conclusions PES improves swallowing function and reduces dysphagia severity in patients with acute stroke. It increases the likelihood of nasogastric tube removal, improves oral intake, and shortens hospital stay, while remaining safe and well tolerated, supporting its use as an effective adjunct in stroke rehabilitation. Conflict of interest Khalid Sarhan: nothing to disclose. Rashad Gamaleldin Mohamed Rashad Mohamed: nothing to disclose.