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LVC Timing in Infant Pig Swallowing and the Effect of Safe Swallowing

AbstractRecurrent laryngeal nerve (RLN) injury in neonates, a complication of head and neck surgeries, leads to increased aspiration risk and swallowing dysfunction. The severity of resulting sequelae range from morbidity, such as aspiration pneumonia, to mortality from infection and failure to thrive. The timing of airway protective events including laryngeal vestibule closure (LVC) is implicated in aspiration. We unilaterally transected the RLN in an infant pig model to observe changes in the timing of swallowing kinematics with lesion and aspiration. We recorded swallows using high-speed video-fluoroscopic swallow studies (VFSS) and scored them using the Infant Mammalian Penetration and Aspiration Scale (IMPAS). We hypothesized that changes would occur in swallowing kinematics (1) between RLN lesion and control animals, and (2) among safe swallows (IMPAS 1), penetration swallows (IMPAS 3), and aspiration swallows (IMPAS 7). We observed numerous changes in timing following RLN lesion in safe and unsafe swallows, suggesting pervasive changes in the coordination of oropharyngeal function. The timing of LVC, posterior tongue, and hyoid movements differed between pre- and post-lesion in safe swallows. Posterior tongue kinematics differed for post-lesion swallows with penetration. The timing and duration of LVC and posterior tongue movement differed between aspiration swallows pre- and post-lesion. After lesion, safe swallows and swallows with aspiration differed in timing of LV...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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CONCLUSIONS: In 8.4% of cases, VAP was the leading cause of death in our study. This indicates that the patients died more frequently with VAP rather than because of it. PMID: 29239151 [PubMed - as supplied by publisher]
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
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Source: Nagoya Journal of Medical Science - Category: International Medicine & Public Health Tags: Nagoya J Med Sci Source Type: research
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Source: IDCases - Category: Infectious Diseases Source Type: research
Publication date: January 2018 Source:The Lancet Global Health, Volume 6, Issue 1 Author(s): Kim Mulholland
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
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Source: Journal of Neurology - Category: Neurology Source Type: research
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Source: Microbial Pathogenesis - Category: Infectious Diseases Source Type: research
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Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
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Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
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Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
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Source: Veterinary Immunology and Immunopathology - Category: Veterinary Research Source Type: research
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