Effects of Head and Neck Alignment and Pharyngeal Anatomy on Epiglottic Inversion During Swallowing in Dysphagic Patients
This study investigated the factors involved in epiglottic inversion, including head and neck alignment and pharyngeal anatomy, in patients with dysphagia. Patients with a chief complaint of dysphagia and who underwent videofluoroscopic swallowing study at our hospital from January to July 2022 were enrolled. They were divided into three groups based on the degree of epiglottic inversion as the complete-inversion (CI), partial-inversion (PI), and non-inversion group (NI) groups. Data were compared among the three groups; a total of 113 patients were analyzed. The median age was 72.0 (IQR: 62.0 –76.0) years; 41 (36.3%) an...
Source: Dysphagia - May 6, 2023 Category: Speech-Language Pathology Source Type: research
Brain and Pharyngeal Responses Associated with Pharmacological Treatments for Oropharyngeal Dysphagia in Older Patients
AbstractImpaired pharyngo-laryngeal sensory function is a critical mechanism for oropharyngeal dysphagia (OD). Discovery of the TRP family in sensory nerves opens a window for new active treatments for OD. To summarize our experience of the action mechanism and therapeutic effects of pharyngeal sensory stimulation by TRPV1, TRPA1 and TRPM8 agonists in older patients with OD. Summary of our studies on location and expression of TRP in the human oropharynx and larynx, and clinical trials with acute and after 2 weeks of treatment with TRP agonists in older patients with OD. (1) TRP receptors are widely expressed in the huma...
Source: Dysphagia - May 5, 2023 Category: Speech-Language Pathology Source Type: research
Efficacy of Transcranial Direct Current Stimulation Combined with Conventional Swallowing Rehabilitation Training on Post-stroke Dysphagia
AbstractTo observe the clinical effects of transcranial direct current stimulation (tDCS) combined with conventional swallowing rehabilitation training on post-stroke dysphagia and explore its long-term efficacy. A total of 40 patients with dysphagia after the first stroke were randomly divided into a treatment group (n = 20) and a conventional group (n = 20). The treatment group received tDCS combined with conventional swallowing rehabilitation training, while the conventional group only received conventional swallowing rehabilitation training. The Standardized Swallowing Assessment (SSA) Scale and the Penetration...
Source: Dysphagia - May 5, 2023 Category: Speech-Language Pathology Source Type: research
Single-Versus Multiple-Dose Antimicrobial Prophylaxis in Peroral Endoscopic Myotomy: A Randomized Controlled Study (SMAPP Trial)
In this study, we aimed to determine the difference in the rate of infections between single (SD-A) and multiple doses (MD-A) antibiotic prophylaxis groups. The study was a prospective, randomized, non-inferiority trial conducted at a single tertiary care centre from Dec 2018 to Feb 2020. Eligible patients undergoing POEM were randomized into SD-A and MD-A groups. SD-A group received one dose of antibiotic (IIIrd gen cephalosporin) within 30-min of POEM. In the MD-A group, the same antibiotic was administered for a total of three days. Primary aim of the study was to determine the incidence of infections in the two groups....
Source: Dysphagia - May 4, 2023 Category: Speech-Language Pathology Source Type: research
The Role of Bolus Residue and Its Relation with Respiratory Problems in Children with Esophageal Atresia
AbstractBolus residue is significant risk factor for postswallow aspiration. A retrospective study was performed to evaluate the role of bolus residue and its relation with respiratory problems in children with esophageal atresia. Children were evaluated for demographic features, type of esophageal atresia, associated anomalies, and respiratory problems. The videofluoroscopic swallowing evaluation (VFSE) was performed, and scored by using the penetration aspiration scale (PAS), bolus residual score (BRS) and normalized residual ratio scale (NRRS). Children with and without respiratory problems were also compared in terms o...
Source: Dysphagia - May 3, 2023 Category: Speech-Language Pathology Source Type: research
Impact of Quantitative Videofluoroscopic Swallowing Measures on Clinical Interpretation and Recommendations by Speech-Language Pathologists
This study explores agreement between traditional observational analysis and quantitative analysis, and the impact of analytical approaches on subsequent diagnosis and recommendations. One hundred adults referred for VFSSs with swallowing concerns were administered a standardised VFSS protocol. All VFSSs were analysed using three approaches: (1) a traditional observational analysis typically used by treating speech-language pathologists (SLPs), (2) quantitative analysis by two independent raters, and (3) binary subjective analysis by 11 independent raters. Three metrics were focussed on; pharyngeal constriction (PC), hyoid...
Source: Dysphagia - May 1, 2023 Category: Speech-Language Pathology Source Type: research
Surface Electromyography for Evaluating the Effect of Aging on the Coordination of Swallowing Muscles
This study evaluated the temporal events observed by sEMG to clarify how aging affects the coordination among the masticatory and suprahyoid muscles. We recruited elderly individuals (over 65 years old) who denied dysphagia. The sEMG activities of anterior temporalis, masseter, and suprahyoid muscles were recorded during 3, 15, and 30 ml water swallowing tests (WST). We calculated the time interval between anterior temporalis and suprahyoid peak activity (T-SH interval) and masseter a nd suprahyoid peak activity (M-SH interval) and analyzed their correlation with age. The subjects who could and could not swallow 30 ml ...
Source: Dysphagia - April 27, 2023 Category: Speech-Language Pathology Source Type: research
Defining Normal Sequential Swallowing Biomechanics
This study investigated sequential swallowing biomechanics in healthy adults. Archival normative videofluoroscopic swallow studies were analyzed for hyolaryngeal complex (HLC) patterning and biomechanical measures from the first 2 swallows of a 90-mL thin liquid sequential swallow task. The effects of age, sex, HLC type, and swallow order were explored. Eighty-eight participants were included in the primary analyses as they performed sequential swallows. HLC Type I (airway opens, epiglottis approaches baseline) and Type II (airway remains closed, epiglottis remains in verted) most commonly occurred (47% each), followed by ...
Source: Dysphagia - April 25, 2023 Category: Speech-Language Pathology Source Type: research
Surface Electromyography of Pharyngeal Swallowing in Healthy Chinese Individuals: Establishment of a Timing and Amplitude Database
This study determined the surface electromyography (sEMG) characteristics of healthy Chinese adults during swallowing to provide a reference for the clinical differential diagnosis of swallowing and dysphagia. sEMG was performed on 187 healthy adults to obtain quantitative information on normal pharyngeal swallowing. The evaluated parameters included the timing and amplitude of sEMG activity in the submental and infrahyoid muscles. A normative database was constructed for the timing and amplitude of muscle activity during pharyngeal swallowing. Results indicated that the duration of sEMG activity was related to the age of ...
Source: Dysphagia - April 24, 2023 Category: Speech-Language Pathology Source Type: research
Association of the “Jet Phenomenon” with Positive Symptom Outcome Following Surgical Treatment of Cricopharyngeus Muscle Dysfunction
ConclusionThis study provides the initial report on the utility of JP as a VFSS feature that is strongly associated with improved outcomes following surgical treatment of CPMD. Further work determining the physiologic correlates responsible for JP will help clarify its predictive capabilities.Level of EvidenceLevel 3. (Source: Dysphagia)
Source: Dysphagia - April 24, 2023 Category: Speech-Language Pathology Source Type: research
Comparison of Oropharyngeal Dysphagia Before and After Botulinum Toxin Injection in Cervical Dystonia
AbstractCervical dystonia (CD) is the most common form of focal dystonia with Botulinum neurotoxin (BoNT) being a frequent method of treatment. Dysphagia is a common side effect of BoNT treatment for CD. Instrumental evaluation of swallowing in CD using standardized scoring for the videofluoroscopic swallowing study (VFSS) and validated and reliable patient-reported outcomes measures is lacking in the literature. (1) to determine if BoNT injections change instrumental findings of swallowing function using the Modified Barium Swallow Impairment Profile (MBSImP) in individuals with CD; (2) to determine if BoNT injections cha...
Source: Dysphagia - April 18, 2023 Category: Speech-Language Pathology Source Type: research
Quantitative Analysis of Temporal Parameters Correlated with Aspiration and Lesion Location in Stroke Patients
AbstractThe purpose of this study was to identify differences in temporal parameters correlating to the presence of aspiration and the severity of penetration-aspiration scale (PAS) in patients with dysphagia after stroke. We also investigated whether there was a significant difference in temporal parameters based on the location of the stroke lesion. A total of 91 patient videofluoroscopic swallowing study (VFSS) videos of stroke patients with dysphagia were retrospectively analyzed. Various temporal parameters including oral phase duration, pharyngeal delay time, pharyngeal response time, pharyngeal transit time, larynge...
Source: Dysphagia - April 18, 2023 Category: Speech-Language Pathology Source Type: research
Race and Gender Influences the Presentation of Eosinophilic Esophagitis
AbstractOur understanding of the influence of race and gender on the presentation of eosinophilic esophagitis (EoE) is incomplete. To address this gap, we examined the effect of race and gender on the presentation of EoE. In this retrospective study, we reviewed the medical records of 755 EoE patients and recorded their demographic, clinical, endoscopic, and histologic information. Descriptive statistics were used to characterize the cohort. Multivariate logistic regression was used to identify predictors of race and gender after accounting for potential confounders. There was a bimodal distribution for age at diagnosis of...
Source: Dysphagia - April 17, 2023 Category: Speech-Language Pathology Source Type: research
Prevalence, Incidence, and Predictors of Self-reported Swallowing Difficulties in Community-Dwelling Adults: A Population-Based Study from the Canadian Longitudinal Study on Aging (CLSA)
AbstractThere is a paucity of evidence from population-based studies identifying prevalence and incidence of dysphagia, as well as health and sociodemographic risk factors that may contribute to its development. As such, the current study aimed to determine prevalence, incidence, and associated predictors of dysphagia in adults. The Canadian Longitudinal Study on Aging is a nationally representative population study that follows 51,338 Canadians over 45 years of age. Biological, medical, psychological, social, lifestyle and economic data are collected. A secondary analysis of the data was conducted to determine prevalenc...
Source: Dysphagia - April 9, 2023 Category: Speech-Language Pathology Source Type: research
Electrokinesiographic Study of Oropharyngeal Swallowing in Neurogenic Dysphagia
AbstractElectrokinesiographic study of swallowing (EKSS) can be useful for the assessment of patients with suspected or overt neurogenic dysphagia. EKSS consists of multichannel recording of the electromyographic (EMG) activity of the suprahyoid/submental muscle complex (SHEMG), the EMG activity of the cricopharyngeal muscle (CPEMG), and the laryngopharyngeal mechanogram (LPM). The LPM is an expression of the mechanical changes that the laryngopharyngeal structures undergo during the pharyngeal phase of swallowing. This method allows detailed evaluation of the magnitude, duration and temporal relations of the different eve...
Source: Dysphagia - March 11, 2023 Category: Speech-Language Pathology Source Type: research
