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Double Blind Study Investigating the Effect of Different Voice Prostheses on Ease of Swallowing and Residue Post Laryngectomy
This study investigated the difference between six commonly available voice prostheses in terms of swallowing. Laryngectomy patients had up to six voice prostheses placed in a random order over two visits. Swallowing was evaluated for each prosthesis using FEES (Fibreoptic Endoscopic Evaluation of Swallowing). After each prosthesis trial, patients self-evaluated their experience of swallowing. Three independent experts indicated which prosthesis they considered best for swallowing for each patient and judged residue on the voice prosthesis and in the upper esophagus. Raters were blinded to participant details, voice prosth...
Source: Dysphagia - February 19, 2018 Category: Speech-Language Pathology Source Type: research

Superior and Anterior Hyoid Displacement During Swallowing in Non-Dysphagic Individuals
AbstractThe Dynamic Swallow Study (DSS) is a methodology used to objectively and quantitatively assess swallowing kinematics during Videofluoroscopic Swallow Studies (VFSS). No DSS normative data exist delineating superior and anterior hyoid displacement (Hsup andHant, respectively), nor the ratio betweenHsup andHant (SAratio). The aims of this study were to (1) establish normative data forHsup,Hant, and SAratio and (2) assess the effects of age, sex, and bolus size on these measures in non-dysphagic patients, within the context of DSS. VFSSs were reviewed for consecutive elderly ( ≥ 65 years) and non-elderly (
Source: Dysphagia - February 14, 2018 Category: Speech-Language Pathology Source Type: research

Short-Term Effects of Cold Liquids on the Pharyngeal Swallow in Preterm Infants with Dysphagia: A Pilot Study
AbstractCold stimulation reduces airway compromise in adults with dysphagia. However, there is no sufficient evidence to support its use in the pediatric population. The primary goal of this pilot study is to assess the effect of cold liquid on the pharyngeal swallow mechanism in preterm infants with dysphagia. We hypothesized that thermal stimulation from cold liquid will decrease the risk of airway compromise in dysphagic preterm infants. Nine preterm infants with clinical symptoms of dysphagia were included. Video fluoroscopic swallow studies were used to assess the swallowing mechanism of each participant. The occurren...
Source: Dysphagia - February 12, 2018 Category: Speech-Language Pathology Source Type: research

Interdisciplinary Telemedicine in the Management of Dysphagia in Head and Neck
AbstractThe study considered the feasibility and impact of interdisciplinary telemedicine discussions in the management of post-treatment dysphagia in patients with head and neck tumors. This is a retrospective analysis of patients with persistent dysphagia after treatment for head and neck pathology, at an institute in India. The cases were discussed in the telemedicine meeting conducted between host institute and a second unit in the United States. A monthly meeting was organized, using an internet-based video conference system. The ongoing swallowing problems and management were presented, and through discussions, a pla...
Source: Dysphagia - February 5, 2018 Category: Speech-Language Pathology Source Type: research

Using Rasch Analysis to Evaluate the Reliability and Validity of the Swallowing Quality of Life Questionnaire: An Item Response Theory Approach
This study describes the reliability and validity of the SWAL-QOL using item response theory (IRT; Rasch analysis). SWAL-QOL data were gathered from 507 participants at risk of oropharyngeal dysphagia (OD) across four European countries. OD was confirmed in 75.7% of participants via videofluoroscopy and/or fiberoptic endoscopic evaluation, or a clinical diagnosis based on meeting selected criteria. Patients with esophageal dysphagia were excluded. Data were analysed using Rasch analysis. Item and person reliability was good for all the items combined. However, person reliability was poor for 8 subscales and item reliabilit...
Source: Dysphagia - February 1, 2018 Category: Speech-Language Pathology Source Type: research

Laryngeal Manipulation for Dysphagia with Muscle Tension Dysphonia
AbstractThe purpose of the article is to describe the use of laryngeal manipulation as a treatment for dysphagia resulting from excessive paralaryngeal muscle tension and to identify the patients likely to have symptomatic improvement. This is a retrospective single-center case series. A retrospective review identified patients from 2007 to 2013 with laryngeal manipulation for muscle tension dysphagia in an academic Otolaryngology practice. Subjects with dysphagia not attributable to an anatomic cause who attended therapy at least one time were included in the study. The primary outcome of the study was subjective improvem...
Source: Dysphagia - January 25, 2018 Category: Speech-Language Pathology Source Type: research

Temporal Analysis of Factors Associated with EAT-10 in Outpatients with Oropharyngeal Dysphagia from a Tertiary Care Clinic
The objective of this work was to identify factors (demographics, clinical variables, swallowing physiology, health-related quality of life) associated with longitudinal change in EAT-10 scores in outpatients with oropharyngeal dysphagia at a multi-disciplinary, tertiary care clini c. All patients with swallowing concerns that were included in the UW Madison Voice and Swallowing Outcomes database from 12/2012 to 04/2015 were invited to complete EAT-10 and a general health-related quality of life survey (SF-12v2) at their initial evaluation and six months later. Forty-two pati ents were included in analysis (n =&n...
Source: Dysphagia - January 20, 2018 Category: Speech-Language Pathology Source Type: research

An Investigation of the Post-laryngectomy Swallow Using Videofluoroscopy and Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
This study investigates the post-laryngectomy swallow. Presence and degree of residue on the post-laryngectomy swallow as observed on videofluoroscopy and FEES is described. In addition, videofluoroscopy and FEES are assessed for reliability and inter-instrument agreement. 30 laryngectomy subjects underwent dysphagia evaluation using simultaneous videofluoroscopy and FEES. These were reviewed post-examination by three expert raters using a rating scale designed for this purpose. Raters were blinded to subject details, type of laryngectomy surgery, pairing of FEES and videofluoroscopy examinations and the scores of other ra...
Source: Dysphagia - January 19, 2018 Category: Speech-Language Pathology Source Type: research

Validation and Psychometric Properties of the German Version of the SWAL-QOL
This study aimed to establish a German version of the SWAL-QOL (G-SWAL-QOL) using a standardized translation procedure and to systematically evaluate its psychometric properties. The original SWAL-QOL was translated into German following international translation guidelines. A pilot study (45 subjects) confirmed comprehensibility of the G-SWAL-QOL. A consecutive series of 158 subjects (103 patients with dysphagia; 55 healthy controls) was then recruited to assess validity and reliability of the G-SWAL-QOL. Con struct validity was analyzed through a correlation analysis with both (i) the Anderson Dysphagia Inventory (ADI-D)...
Source: Dysphagia - January 8, 2018 Category: Speech-Language Pathology Source Type: research

Open-Cup Drinking Development: A Review of the Literature
AbstractTo date, a lack of published research studies exist that systematically analyze the factors involved with the progression of open-cup drinking in typically developing infants and toddlers. As a result, clinicians who are working with children that have delays in open-cup drinking development have a limited framework from which to base clinical decisions. The purpose of this review is to collate works from disparate and related fields to provide a brief review of the literature of pertinent sensorimotor and cognitive components necessary for successful open-cup drinking development. (Source: Dysphagia)
Source: Dysphagia - December 29, 2017 Category: Speech-Language Pathology Source Type: research

The Mendelsohn Maneuver and its Effects on Swallowing: Kinematic Analysis in Three Dimensions Using Dynamic Area Detector CT
This study investigated the effects of Mendelsohn maneuver with three-dimensional kinematic analysis. Nine female speech-language pathologists (nine females, mean  ± SD 27.1 ± 3.5 years old) underwent 320-row area detector scan during swallows of 4-ml nectar-thick liquid using with no maneuvers (control) and with Mendelsohn maneuver (MM). Critical event timing (hyoid, soft palate, epiglottis, laryngeal vestibule, true vocal cords (TVC), UES), hyoid and laryngeal excursion, cross-sectional area of UES, and volume of pharyngeal cavity and bolus were measured and compared between two swa...
Source: Dysphagia - December 26, 2017 Category: Speech-Language Pathology Source Type: research

Utility of Pulse Oximetry to Detect Aspiration: An Evidence-Based Systematic Review
AbstractPulse oximetry is a commonly used means to measure peripheral capillary oxyhemoglobin saturation (SpO2). Potential use of pulse oximetry to detect aspiration is attractive to clinicians, as it is readily available, quick, and noninvasive. However, research regarding validity has been mixed. This systematic review examining evidence on the use of pulse oximetry to detect a decrease in SpO2 indicating aspiration during swallowing is undertaken to further inform clinical practice in dysphagia assessment. A multi-engine electronic search was conducted on 8/25/16 and updated on 4/8/17 in accordance with standards publis...
Source: Dysphagia - December 14, 2017 Category: Speech-Language Pathology Source Type: research

Effect of Body Position on Pharyngeal Swallowing Pressures Using High-Resolution Manometry
AbstractThe effect of body position and gravitational pull on the complex pressure-driven process of pharyngeal swallowing remains unknown. Using high-resolution manometry (HRM), this study aims to identify positional adaptations of pharyngeal physiology by evaluating swallowing pressure patterns in a series of inverted body positions. Ten healthy adults each underwent swallowing tasks with pharyngeal HRM at six body positions using an inversion table  (0°[upright], 45°, 90°[supine], 110°, 135°, and 180°[fully inverted]). Repeated measures ANOVA was used to assess impact of position on pressure...
Source: Dysphagia - December 7, 2017 Category: Speech-Language Pathology Source Type: research

Functional Cause of Dysphagia Improved with Cognitive Behavioural Treatment
(Source: Dysphagia)
Source: Dysphagia - December 6, 2017 Category: Speech-Language Pathology Source Type: research

Relationship Between Frequency of Spontaneous Swallowing and Salivary Substance P Level in Patients with Acute Stroke
AbstractThe frequency of spontaneous swallowing is useful for screening of dysphagia in acute stroke. Low levels of substance P (SP) in saliva attenuate the swallowing reflex. The aim of this study was to determine the relationship between the frequency of spontaneous swallowing and salivary SP levels. In 40 subjects, saliva was collected within 72  h after stroke onset and salivary SP levels were measured using ELISA kit at a later date. The frequency of spontaneous swallowing was measured over 1 h using a microphone placed on the neck. Pneumonia was diagnosed by the presence of pyrexia and at least two respirat...
Source: Dysphagia - November 28, 2017 Category: Speech-Language Pathology Source Type: research

Tongue Pressure Production and Submental Surface Electromyogram Activities During Tongue-Hold Swallow with Different Holding Positions and Tongue Length
AbstractOur previous study regarding the tongue-hold swallow (THS) demonstrated that the tongue-to-palate contact during THS could be influenced by the maximum tongue protrusion length (MTPL) of individual subjects, resulting in two different patterns of pressure generation. The present study further analyzed the influence of MTPL on the tongue pressure production along with submental surface electromyography (sEMG) during THS, in order to establish an index to better control THS effects. Tongue pressure using a sensor sheet system and concurrent submental sEMG activities were measured during swallowing tasks in 18 healthy...
Source: Dysphagia - November 24, 2017 Category: Speech-Language Pathology Source Type: research

Alterations to Swallowing Physiology as the Result of Effortful Swallowing in Healthy Seniors
This study sought to quantify the immediate kinematic, temporal, and functional changes during an ES maneuver to quantify its exercise potential to combat age-related changes in swallowing. Videofluoroscopy data were collected from 44 healthy seniors (21 male) over 65  years old (mean = 76.9, SD = 7.1). Each participant swallowed six 5 ml boluses of Varibar nectar-thick liquids: three with regular effort and three using ES. Individual swallows (n = 260) were measured on pharyngeal constriction, pharyngeal shortening, laryngeal closure duration, hyoid movement duration, UES opening du...
Source: Dysphagia - November 17, 2017 Category: Speech-Language Pathology Source Type: research

Dysphagia in Multiple Sclerosis: Evaluation and Validation of the DYMUS Questionnaire
ConclusionEvaluation of the DYMUS resulted in a shortened version of the questionnaire with five questions related to dysphagia. This shortened version is considered an easy and useful tool in identifying patients with MS-related dysphagia. (Source: Dysphagia)
Source: Dysphagia - November 17, 2017 Category: Speech-Language Pathology Source Type: research

A Dramatic Case of Odynophagia
We report the case of a 77-year-old male with a history of aortic stenosis and interstitial lung disease, who debuted 3  years ago with an outbreak of necrotic and very painful canker sores. The severity of the lesions and their refractory response to treatment led to several hospital admissions and multiple consultations to different specialists (ENT, rheumatology, dermatology, ophthalmology, cardiology, and intern al medicine). During this time, the patient received central parenteral nutrition with an episode of catheter-related septicemia, and he came to require psychiatric assistance for autolytic ideation. Numer...
Source: Dysphagia - November 11, 2017 Category: Speech-Language Pathology Source Type: research

Evaluation of Swallow Function in Patients with Craniofacial Microsomia: A Retrospective Study
AbstractCraniofacial microsomia (CFM) is characterized by underdevelopment of the structures derived from the first and second pharyngeal arches resulting in aesthetic, psychological, and functional problems including feeding and swallowing difficulties. The aim of this study is to gain more insight into swallowing difficulties in patients with CFM. A retrospective study was conducted in the population of patients diagnosed with CFM at three major craniofacial units. Patients with feeding difficulties and those who underwent video fluoroscopic swallow (VFS) studies were included for further analyses. The outcome of the VFS...
Source: Dysphagia - November 4, 2017 Category: Speech-Language Pathology Source Type: research

Evaluation of an Automated Swallow-Detection Algorithm Using Visual Biofeedback in Healthy Adults and Head and Neck Cancer Survivors
This study evaluated the performance of the swallow-detection algorithm. Ten healthy participants and 10 head and neck cancer (HNC) patients were fitted with the device. Signal was acquired during regular, effortful, and Mendelsohn maneuver saliva swallows, as well as lip presses, tongue, and head movements. Signals of interest were tagged during data acquisition and used to evaluate algorithm performance. Sensitivity and positive predictive values (PPV)  were calculated for each participant. Saliva swallows were compared between HNC and controls in the four sEMG-based parameters used in the algorithm: duration, peak ...
Source: Dysphagia - November 2, 2017 Category: Speech-Language Pathology Source Type: research

Modification of Masticatory Rhythmicity Leading to the Initiation of the Swallowing Reflex in Humans
AbstractModification of movements by proprioceptive feedback during mastication has an important role in shifting from the oral to the pharyngeal phase of swallowing. The aim of this study was to investigate the kinetics of masticatory muscles throughout a sequence of oropharyngeal swallowing and to present a hypothetical model of the involvement of the nervous system in the transition from mastication to the swallowing reflex. Surface electromyographic signals were recorded from the jaw-closing masseter muscles and the jaw-opening suprahyoid muscle group when a piece of bread (3 –5 g) was ingested. Participants...
Source: Dysphagia - November 2, 2017 Category: Speech-Language Pathology Source Type: research

Computational Analysis of Pharyngeal Swallowing Mechanics in Patients with Motor Neuron Disease: A Pilot Investigation
AbstractSwallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (D...
Source: Dysphagia - October 20, 2017 Category: Speech-Language Pathology Source Type: research

Inter-rater Reliability of the Dysphagia Outcome and Severity Scale (DOSS): Effects of Clinical Experience, Audio-Recording and Training
This study investigated inter-rater reliability (IRR) of the DOSS. It also determined the effect of clinical experience, VFSS audio-recording and training on DOSS IRR. A quantitative prospective research design was used. Seventeen speech and language pathologists (SLPs) were recruited from an acute teaching hospital, Dublin (>  3 years’ VFSS experience,n = 10) and from a postgraduate dysphagia programme in a university setting (
Source: Dysphagia - October 19, 2017 Category: Speech-Language Pathology Source Type: research

Tongue-Strengthening Exercises in Healthy Older Adults: Specificity of Bulb Position and Detraining Effects
This study suggests that TSE show partial specificity concerning bulb position. We conclude that especially anterior training results in higher anterior TS in comparison with posterior exercises. Furthermore, we found no detraining effects, independent of bulb loc ation. (Source: Dysphagia)
Source: Dysphagia - October 19, 2017 Category: Speech-Language Pathology Source Type: research

A Significant Association of Malnutrition with Dysphagia in Acute Patients
AbstractDysphagia and malnutrition seem to be associated, but little research in detail has been reported. We aimed to clarify the association between dysphagia and malnutrition by adopting accurate diagnosis and mathematical evaluation of dysphagia using videofluorography and nutritional assessment calculated by a well-established nutritional risk index. We conducted a retrospective analysis of 165 enrolled patients who were admitted to our hospital for acute diseases and underwent videofluorography on suspicion of dysphagia in the year 2016. We diagnosed high-risk dysphagia in patients with 8-point penetration –asp...
Source: Dysphagia - October 11, 2017 Category: Speech-Language Pathology Source Type: research

Lesions Responsible for Delayed Oral Transit Time in Post-stroke Dysphagia
ConclusionDelayed oral phase in post-stroke patients was not negligible clinically. Patients ’ cognitive impairments affect the oral transit time. When adjusting it, we found a trend that the lesion responsible for delayed oral phase was located in the left frontal lobe, though the association did not reach significance. The delay might be related to praxis function. (Source: Dysphagia)
Source: Dysphagia - October 11, 2017 Category: Speech-Language Pathology Source Type: research

Effects of Mechanical Complications on Radiation Exposure During Fluoroscopically Guided Gastrojejunostomy Exchange in the Pediatric Population
AbstractThe purpose of the article is to evaluate the effects of mechanical complications, such as clogging or coiling, of gastrojejunostomy tubes on radiation exposure during exchange in the pediatric population. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed procedural records for patients undergoing gastrojejunostomy (GJ) tube exchange during a 4-month period in 2014. Success of the procedure, specifications of the tube, age, and sex of the patient as well as radiation exposure during the procedure were included. Radiation exposure was measured in fluoroscopy time and cumulative air kerma. C...
Source: Dysphagia - October 7, 2017 Category: Speech-Language Pathology Source Type: research

Patient Adherence to Dysphagia Recommendations: A Systematic Review
AbstractPatient adherence to treatment recommendations is an important issue for healthcare providers, in a multitude of specialties, and is critical when assessing the efficacy and effectiveness of a particular treatment approach. Patients who have swallowing impairment often require complex and specific interventions requiring altered daily patterns of behavior. Patients with dysphagia who do not follow recommendations or prescribed exercises may not receive maximum benefit of an intervention. Poor adherence also makes it more difficult to evaluate efficacy of a treatment both clinically and in experimental settings. Fur...
Source: Dysphagia - September 30, 2017 Category: Speech-Language Pathology Source Type: research

Feasibility of a Mobile Application to Enhance Swallowing Therapy for Patients Undergoing Radiation-Based Treatment for Head and Neck Cancer
AbstractDysphagia following treatment for head and neck cancer is one of the most significant morbidities impacting quality of life. Despite the value of prophylactic exercises to mitigate the impact of radiation on long-term swallowing function, adherence to treatment is limited. The purpose of this investigation was to explore the feasibility of a mobile health application to support patient adherence to swallowing therapy during radiation-based treatment. 36 patients undergoing radiation therapy were provided with the Vibrent ™ mobile application as an adjunct to standard swallowing therapy. The application includ...
Source: Dysphagia - September 30, 2017 Category: Speech-Language Pathology Source Type: research

A Survey of Australian Dysphagia Practice Patterns
AbstractDysphagia assessment and rehabilitation practice is complex, and significant variability in speech-language pathology approaches has been documented internationally. The aim of this study was to evaluate swallowing-related assessment and rehabilitation practices of SLPs currently working in Australia. One hundred and fifty-four SLPs completed an online questionnaire administered via QuickSurveys from May to July 2015. Results were analysed descriptively. The majority of clinicians had accessed post-graduate training in dysphagia management and assessment (66.23%). Referral and screening were typically on anad hoc b...
Source: Dysphagia - September 20, 2017 Category: Speech-Language Pathology Source Type: research

Reply to the Letter to the Editor  Concerning: ‘Changes in Swallowing-Related Quality of Life After Endoscopic Treatment for Zenker’s Diverticulum Using SWAL-QOL Questionnaire’
(Source: Dysphagia)
Source: Dysphagia - September 20, 2017 Category: Speech-Language Pathology Source Type: research

Effectiveness of a New Lead-Shielding Device and Additional Filter for Reducing Staff and Patient Radiation Exposure During Videofluoroscopic Swallowing Study Using a Human Phantom
AbstractInterventional radiology procedures often involve lengthy exposure to fluoroscopy-derived radiation. We therefore devised a videofluoroscopic swallowing study (VFSS) procedure using a human phantom that proved to protect the patient and physician by reducing the radiation dose. We evaluated a new lead-shielding device and separately attached additional filters (1.0-, 2.0-, and 3.0-mm Al filters and a 0.5-mm Cu filter) during VFSS to reduce the patient ’s entrance skin dose (ESD). A monitor attached to the human phantom’s neck measured the ESD. We also developed another lead shield (VFSS Shielding Box, 1...
Source: Dysphagia - September 18, 2017 Category: Speech-Language Pathology Source Type: research

First Steps Towards Development of an Instrument for the Reproducible Quantification of Oropharyngeal Swallow Physiology in Bottle-Fed Children
AbstractThe incidence of feeding/swallowing impairments (deglutition disorders) in young children is rising and poses serious acute and long-term health consequences. Accurate detection and prompt intervention can lessen the impact of dysphagia-induced sequelae. Videofluoroscopic Swallow Studies (VFSSs) are used to make critical decisions for medically fragile children despite procedural variability and the lack of agreed upon measures for interpreting and reporting results. This investigation represents the first steps in the development of a novel tool for the quantification of oropharyngeal swallow physiology from full-...
Source: Dysphagia - September 11, 2017 Category: Speech-Language Pathology Source Type: research

Correlations Between Patient-Reported Dysphagia Screening and Penetration –Aspiration Scores in Head and Neck Cancer Patients Post-oncological Treatment
AbstractDysphagia is a common and severe toxicity after oncological treatment of head and neck cancer (HNC). The study aim was to investigate relationships between patient-reported dysphagia and clinically measured swallowing function in HNC after modern curative radiotherapy with or without chemotherapy to identify possible alarm symptoms for clinically manifest dysphagia. Patients with tumors of the tonsil, base of tongue, hypopharynx, and larynx treated in 2007 –2015 were assessed for dysphagia post-treatment by telephone interview and videofluoroscopy (VFS). A study-specific categorized symptom score was used to ...
Source: Dysphagia - September 8, 2017 Category: Speech-Language Pathology Source Type: research

A Pilot Study of Perceived Mouth Dryness, Perceived Swallowing Effort, and Saliva Substitute Effects in Healthy Adults Across the Age Range
This study: (1) quantified relationships among age, perceived sense of swallowing effort, and ratings of perceived mouth dryness, and (2) examined changes in swallowing effort following application of a gel-based saliva substitute in healthy participants. This was a cross-sectional observational study and data were collected from attendees of a community healthy aging fair. Forty-two healthy participants (mean age  = 65 years; 20 female) were enrolled. Each participant rated perceived effort with swallowing and perceived mouth dryness on a 10-cm horizontal, undifferentiated line. After participants applied a...
Source: Dysphagia - September 6, 2017 Category: Speech-Language Pathology Source Type: research

Health-Related Quality of Life and Oropharyngeal Dysphagia: A Systematic Review
AbstractThe negative impact of increased bolus modification on health-related quality of life (HRQoL) in persons with oropharyngeal dysphagia (OD) has been described in previous literature; however, findings may have been influenced by the severity of OD and underlying etiology. The current systematic review therefore aims to investigate therelationships between HRQoL and OD and to report onchanges in HRQoL and OD following intervention. This review was conducted in accordance with the PRISMA statement. A systematic search of the literature was performed using PubMed and Embase. All available English publications up to Feb...
Source: Dysphagia - September 2, 2017 Category: Speech-Language Pathology Source Type: research

Relationship Between Laryngeal Sensory Deficits, Aspiration, and Pneumonia in Patients with Dysphagia
This study examined if the absence of the LAR in response to touch delivered by a laryngoscope is associated with penetration/aspiration or pneumonia in patients with dysphagia. Inpatients at a teaching hospital with clinical symptoms of dysphagia were recruited upon referral to the otolaryngology clinic for a swallowing evaluation. Otolaryngologists observed the status of secretions and touched each arytenoid with the tip of the laryngoscope. The patients were then asked to swallow 3 –5 mL grape gelatin and 3–5 mL colored water. All procedures were video-recorded. Two independent raters noted absence...
Source: Dysphagia - September 2, 2017 Category: Speech-Language Pathology Source Type: research

Rethinking Residue: Determining the Perceptual Continuum of Residue on FEES to Enable Better Measurement
AbstractThe goal of this work was to better understand perceptual judgments of pharyngeal residue on flexible endoscopic evaluation of swallowing (FEES) and the influence of a visual analog scale (VAS) versus an ordinal scale on clinician ratings. The intent was to determine if perceptual judgments of residue were more accurately described by equal or unequal intervals. Thirty-three speech language pathologists rated pharyngeal residue from 75 FEES videos representing a wide range of residue severities for thin liquid, applesauce, and cracker boluses. Clinicians rated their impression of the overall residue amount in each ...
Source: Dysphagia - August 30, 2017 Category: Speech-Language Pathology Source Type: research

The Criteria of Thickened Liquid for Dysphagia Management in Japan
AbstractIn Japan, the viscosity of thickened liquids is different among hospitals and nursing homes. In order to standardize viscosity of thickened liquids, the dysphagia diet committee of the Japanese Society of Dysphagia Rehabilitation developed the Japanese Dysphagia Diet 2013 (JDD2013). To decide on a definition of thickened liquids, the committee reviewed categories from other countries. Especially, the criteria of the USA and Australia were used as references. The definition had three levels: mildly thick, moderately thick, and extremely thick. Then a sensory evaluation by health care workers was carried out to decid...
Source: Dysphagia - August 30, 2017 Category: Speech-Language Pathology Source Type: research

Reliability and Validity of the MD Anderson Dysphagia Inventory Among Japanese Patients
In conclusion, this study validated the Japanese version of the MDADI and showed that as FOIS scores deteriorate, MDADI-J scores tend to constantly decrease. (Source: Dysphagia)
Source: Dysphagia - August 24, 2017 Category: Speech-Language Pathology Source Type: research

Grading Dysphagia as a Toxicity of Head and Neck Cancer: Differences in Severity Classification Based on MBS DIGEST and Clinical CTCAE Grades
This study aims to inform clinicians on the similarities and differences between dysphagia severity according to clinical CTCAE and MBS-derived DIGEST grading. A cross-sectional sample of 95 MBS studies was randomly selected from a prospectively-acquired MBS database among patients treated with organ preservation strategies for head and neck cancer. MBS DIGEST and clinical CTCAE dysphagia grades were compared. DIGEST and CTCAE dysphagia grades had “fair” agreement per weighted κ of 0.358 (95% CI .231–.485). Using a threshold of DIGEST ≥ 3 as reference, CTCAE had an overall sensitivity o...
Source: Dysphagia - August 23, 2017 Category: Speech-Language Pathology Source Type: research

Cross-Cultural Adaptation and Validation of the SWAL-QoL Questionnaire in Greek
AbstractThe purpose of this study was to translate and adapt the 44-item SWAL-QoL into Greek and examine its internal consistency, test –retest reliability, external construct validity, and discriminant validity in order to provide a validated dysphagia-specific QoL instrument in the Greek language. The instrument was translated into Greek using the back translation to ensure linguistic validity and was culturally adapted resultin g in the SWAL-QoL-GR. Two groups of participants were included: a patient group of 86 adults (48 males; age range: 18–87 years) diagnosed with oropharyngeal dysphagia, and an age-matc...
Source: Dysphagia - August 23, 2017 Category: Speech-Language Pathology Source Type: research

Predictive Value of the New Zealand Secretion Scale (NZSS) for Pneumonia
AbstractAccumulated pharyngo-laryngeal secretions have been associated with aspiration and pneumonia. While traditional secretion scales evaluate location and amount, the eight-point New Zealand Secretion Scale (NZSS) uniquely encompasses a responsiveness subcomponent. This prospective observational study investigated the predictive value of NZSS for aspiration and pneumonia. Consecutive inpatients (N:180) referred for flexible endoscopic evaluation of swallowing (FEES) were recruited (neurological 49%, critical care 31%, structural 15%, other 5% etiologies). Mean age was 63  years (range 18–95 years, S.D. ...
Source: Dysphagia - August 23, 2017 Category: Speech-Language Pathology Source Type: research

Differential Response Pattern of Oropharyngeal Pressure by Bolus and Dry Swallows
AbstractThe aim of this study was to determine if bolus and dry swallow showed similar pressure changes in the oropharynx using our newly developed device. A unique character of it includes that baropressure can be measured with the sensor being placed in the balloon and can assess the swallowing mechanics in terms of pressure changes in the oropharynx with less influences of direct contacts of boluses and oropharyngeal structures during swallow indirectly. Fifteen healthy subjects swallowed saliva (dry), 15  ml of water, 45 ml of water, and 15 ml of two different types of food in terms of viscosity (potage ...
Source: Dysphagia - August 23, 2017 Category: Speech-Language Pathology Source Type: research

Changes in Swallowing-Related Quality of Life After Endoscopic Treatment for Zenker ’s Diverticulum Using the SWAL-QOL Questionnaire
(Source: Dysphagia)
Source: Dysphagia - August 23, 2017 Category: Speech-Language Pathology Source Type: research

Critical Dysphagia is Common in Parkinson Disease and Occurs Even in Early Stages: A Prospective Cohort Study
AbstractTo assess the prevalence of dysphagia and its typical findings in unselected “real-world” Parkinson patients using an objective gold-standard method. This was a prospective, controlled, cross-sectional study conducted in 119 consecutive Parkinson patients of all stages independent of subjective dysphagia. Patients and 32 controls were clinically and endoscopically examin ed by flexible endoscopic evaluation of swallowing (FEES) to evaluate the deglutition with regard to three consistencies (water, biscuit, and bread). Typical findings of dysphagia like penetration and aspiration, residues, and leakage w...
Source: Dysphagia - August 21, 2017 Category: Speech-Language Pathology Source Type: research

Maturation Modulates Pharyngeal-Stimulus Provoked Pharyngeal and Respiratory Rhythms in Human Infants
AbstractPharyngeal-provocation induced aerodigestive symptoms in infants remain an enigma. Sources of pharyngeal provocation can be anterograde as with feeding, and retrograde as in gastroesophageal reflux. We determined maturational and dose –response effects of targeted pharyngeal-stimulus on frequency, stability, and magnitude of pharyngeal and respiratory waveforms during multiple pharyngeal swallowing responses in preterm-born infants when they were of full-term postmenstrual age (PMA). Eighteen infants (11 male) were studied long itudinally at 39.8 ± 4.8 weeks PMA (time-1) and 44.1 ±...
Source: Dysphagia - August 21, 2017 Category: Speech-Language Pathology Source Type: research

Psychometric Characteristics of Non-instrumental Swallowing and Feeding Assessments in Pediatrics: A Systematic Review Using COSMIN
AbstractAs early diagnosis of swallowing and feeding difficulties in infants and children is of utmost importance, there is a need to evaluate the quality of the psychometric properties of pediatric assessments of swallowing and feeding. A systematic review was performed summarizing the psychometric properties of non-instrumental assessments for swallowing and feeding difficulties in pediatrics; no data were identified for the remaining twelve assessments. The COSMIN taxonomy and checklist were used to evaluate the methodological quality of 23 publications on psychometric properties. For each assessment, an overall quality...
Source: Dysphagia - August 17, 2017 Category: Speech-Language Pathology Source Type: research

Spatial Characteristics of Jaw Movements During Chewing in Children with Cerebral Palsy: A Pilot Study
This study compared jaw motion between children with cerebral palsy (CP) and their typically-developing (TD) peers during chewing. The jaw movements of 11 children with spastic CP (GMFCS levels II –V) all of whom were exclusively oral feeders with no reported clinical issues with feeding [mean age = 7.49 (2.30) years; 7 males, 4 females] and 11 age- and sex-matched TD peers [mean age = 7.54 (2.35) years] were recorded using optical motion capture. Participants chewed five trials of thre e different consistencies, including puree, mechanical soft, and solid. For each chewing sequence, the path dist...
Source: Dysphagia - August 9, 2017 Category: Speech-Language Pathology Source Type: research