Swallowing Function

Swallowing function is among the outcomes for which VNS has its strongest and most reliable post-stroke rehabilitation evidence. VNS improvement in swallowing function carries high GRADE evidence certainty, supporting reliable conclusions for this domain. Most material entering the mouth is eventually swallowed unless deliberately spit out. Saliva is swallowed throughout the day without conscious awareness. An unclean tongue is presented as potentially repeatedly feeding or seeding the digestive tract with accumulated tongue-surface material. Swallowing function was newly included as an outcome in this review, extending beyond the narrower focus of prior VNS stroke reviews.