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Clinical Conundrum: Killian-Jamieson Diverticulum with Paraesophageal Hernia
We present a case of a Killian-Jamieson diverticulum associated with a concurrent large type III paraesophageal hernia causing significant solid-food dysphagia, post-prandial regurgitation of solid foods, and chronic cough managed with open transcervical diverticulectomy and laparoscopic paraesophageal hernia repair with Nissen fundoplication. (Source: Dysphagia)
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

‘What About Swallowing?’ Diagnostic Performance of Daily Clinical Practice Compared with the Eating Assessment Tool-10
This study compares the diagnostic performance of a single open question ‘What about swallowing?’ (usual care) with the Eating Assessment Tool (EAT-10) as reference test in screening for oropharyngeal dysphagia (OD). 303 outpatients at risk of OD were recruited at three university hospitals: 162 men and 141 women with a mean age of 70 years. All data were retrieved by phone. To identify patients at risk of dysphagia, two different cut-off scores for the EAT-10 total score were retrieved from the literature. The diagnostic performance of the single question was determined by comparing dichotomized answers t...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review
Abstract Identification of pharyngeal residue severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue severity rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue severity rat...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

Predictive Factors for Prophylactic Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement and Use in Head and Neck Patients Following Intensity-Modulated Radiation Therapy (IMRT) Treatment: Concordance, Discrepancies, and the Role of Gabapentin
Abstract The prophylactic placement of a percutaneous endoscopic gastrostomy (PEG) tube in the head and neck cancer (HNC) patient is controversial. We sought to identify factors associated with prophylactic PEG placement and actual PEG use. Since 2010, data regarding PEG placement and use were prospectively recorded in a departmental database from January 2010 to December 2012. HNC patients treated with intensity-modulated radiation therapy (IMRT) were retrospectively evaluated from 2010 to 2012. Variables potentially associated with patient post-radiation dysphagia from previous literature, and our experience was...
Source: Dysphagia - January 11, 2016 Category: Speech Therapy Source Type: research

The Physiology of Eructation
Abstract Eructation is composed of three independent phases: gas escape, upper barrier elimination, and gas transport phases. The gas escape phase is the gastro-LES inhibitory reflex that causes transient relaxation of the lower esophageal sphincter, which is activated by distension of stretch receptors of the proximal stomach. The upper barrier elimination phase is the transient relaxation of the upper esophageal sphincter along with airway protection. This phase is activated by stimulation of rapidly adapting mechanoreceptors of the esophageal mucosa. The gas transport phase is esophageal reverse peristalsis med...
Source: Dysphagia - December 22, 2015 Category: Speech Therapy Source Type: research

Radiopaque Stomach-Shaped Bezoar in a Suicidal Patient
(Source: Dysphagia)
Source: Dysphagia - December 22, 2015 Category: Speech Therapy Source Type: research

Effects of Effortful Swallow on Cardiac Autonomic Regulation
In conclusion effortful swallow maneuver in healthy women increased sympathetic cardiac modulation, indicating a cardiac overload. (Source: Dysphagia)
Source: Dysphagia - December 9, 2015 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - December 1, 2015 Category: Speech Therapy Source Type: research

A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia
Abstract Thickeners are used in post-stroke oropharyngeal dysphagia (OD) as a compensatory therapeutic strategy against aspirations. To compare the therapeutic effects of modified starch (MS) and xanthan gum (XG) thickeners on swallow safety and efficacy in chronic post-stroke OD patients using clinical and videofluoroscopic (VFS) assessment. Patients were studied by clinical assessment (volume-viscosity swallow test, V-VST) and VFS using 3 volumes (5, 10, 20 mL) and 3 viscosities (liquid, nectar and spoon thick), comparing MS and XG. We studied 122 patients (46MS, 76XG). (A) V-VST showed that both thickeners...
Source: Dysphagia - November 25, 2015 Category: Speech Therapy Source Type: research

Systematic Review: Non-Instrumental Swallowing and Feeding Assessments in Pediatrics
Abstract There is a high incidence of parental reporting of abnormal swallowing and feeding function and the negative impacts thereof on children. As such there is a need for well validated assessments in the area of pediatric swallowing and feeding. While instrumental assessments are well validated, there is limited information available to guide the selection and use of non-instrumental assessments for swallowing and feeding function. The aim of this study was to identify and report on non-instrumental assessments available to clinicians for pediatric swallowing and/or feeding function in order to support clinic...
Source: Dysphagia - November 25, 2015 Category: Speech Therapy Source Type: research

The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing
In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology. (Source: Dysphagia)
Source: Dysphagia - November 25, 2015 Category: Speech Therapy Source Type: research

Dysphagia in Parkinson’s Disease
Abstract More than 80 % of patients with Parkinson’s disease (PD) develop dysphagia during the course of their disease. Swallowing impairment reduces quality of life, complicates medication intake and leads to malnutrition and aspiration pneumonia, which is a major cause of death in PD. Although the underlying pathophysiology is poorly understood, it has been shown that dopaminergic and non-dopaminergic mechanisms are involved in the development of dysphagia in PD. Clinical assessment of dysphagia in PD patients is challenging and often delivers unreliable results. A modified water test assessing maximu...
Source: Dysphagia - November 21, 2015 Category: Speech Therapy Source Type: research

Oral Alimentation in Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula
Abstract Use of high-flow oxygen via nasal cannula (HFO2-NC) is increasingly common in intensive care unit (ICU) settings. Despite the critical interface between respiration and swallowing, and the high acuity of patients in ICUs, the impact of HFO2-NC on feeding and swallowing is unknown. The present prospective, single-center, cohort study investigated the impact of HFO2-NC use on oral alimentation in neonatal and adult ICU patients. Oral alimentation status was evaluated in 100 consecutive ICU inpatients (50 neonatal and 50 adult) requiring HFO2-NC. Participant characteristics, respiratory support, successful i...
Source: Dysphagia - November 21, 2015 Category: Speech Therapy Source Type: research

Swallowing Kinematics and Factors Associated with Laryngeal Penetration and Aspiration in Stroke Survivors with Dysphagia
Abstract The purpose of this study was to investigate swallowing kinematics and explore kinematic factors related with penetration-aspiration in patients with post-stroke dysphagia. Videofluoroscopic images of 68 patients with post-stroke dysphagia and 34 sex- and age-matched healthy controls swallowing a thin liquid were quantitatively analyzed using two-dimensional motion digitization. The measurements included the movement distances and velocities of the hyoid and larynx, and the maximal tilt angles and angular velocities of the epiglottis. All velocity variables were significantly decreased in the stroke patie...
Source: Dysphagia - November 21, 2015 Category: Speech Therapy Source Type: research

Incidence of Pneumonia After Videofluoroscopic Swallowing Study and Associated Factors
In conclusion, the 72-h incidence of VFSS-related pneumonia was 1.0 %. Old age and severity of swallowing difficulty are associated with occurrence of pneumonia. (Source: Dysphagia)
Source: Dysphagia - November 7, 2015 Category: Speech Therapy Source Type: research

The Effect of Capsaicin-Containing Food on the Swallowing Response
Abstract The purpose of this study was to determine the effect of regular ingestion of capsaicin-containing food that is easily available in everyday life on the latency of the swallowing response (LSR). Pickled Napa cabbage was selected as the food for the present study. One portion (10 g) of pickled Napa cabbage provides 1.5 µg of capsaicin. Participants ingested pickled Napa cabbage (10 g) before every meal for 20 days (days 1–20). LSR was measured pre-intervention (day 0) and post-intervention (day 21). The participants then followed their regular diet, without foods containing ...
Source: Dysphagia - November 3, 2015 Category: Speech Therapy Source Type: research

Age-Related Differences in Pressures Generated During Isometric Presses and Swallows by Healthy Adults
Abstract The aim of this prospective observational study was to determine the associations among age, maximum lingual isometric pressures, and maximum swallow pressures in specific regions of the tongue. Individuals 21 years and older who reported normal swallowing were enrolled. Seventy-one healthy adults were stratified by age into young (21–40 years), middle (41–60), and old (61–82) groups. Maximum pressures were measured for each individual during isometric tongue press tasks as well as saliva, 5, and 10 mL thin liquid bolus swallows at 5 sensors located on the hard palate: front, m...
Source: Dysphagia - November 2, 2015 Category: Speech Therapy Source Type: research

Regurgitation of Undigested Food: What is Your Diagnosis?
(Source: Dysphagia)
Source: Dysphagia - October 30, 2015 Category: Speech Therapy Source Type: research

Using Medical Mannequins to Train Nurses in Stroke Swallowing Screening
Abstract Screening patients admitted with stroke symptoms for risk of aspiration is often the responsibility of registered nurses (RNs). Simulation technology has become a widely used evidence-based form of training for healthcare professionals. The purpose of this study was to determine if the use of medical simulation mannequins as a training component is feasible when training and evaluating nurses administering swallowing screenings to stroke patients. A total of 32 RNs were divided into one of two training groups: didactic training only or didactic training plus simulation. Acquisition of skills was asses...
Source: Dysphagia - October 30, 2015 Category: Speech Therapy Source Type: research

A New Accurate 3D Measurement Tool to Assess the Range of Motion of the Tongue in Oral Cancer Patients: A Standardized Model
Abstract In oral cancer treatment, function loss such as speech and swallowing deterioration can be severe, mostly due to reduced lingual mobility. Until now, there is no standardized measurement tool for tongue mobility and pre-operative prediction of function loss is based on expert opinion instead of evidence based insight. The purpose of this study was to assess the reliability of a triple-camera setup for the measurement of tongue range of motion (ROM) in healthy adults and its feasibility in patients with partial glossectomy. A triple-camera setup was used, and 3D coordinates of the tongue in five standardiz...
Source: Dysphagia - October 29, 2015 Category: Speech Therapy Source Type: research

Rare Cause of Acute Dysphagia Associated with Dysphonia
(Source: Dysphagia)
Source: Dysphagia - October 26, 2015 Category: Speech Therapy Source Type: research

Comparison of Two Methods for Inducing Reflex Cough in Patients With Parkinson’s Disease, With and Without Dysphagia
Abstract Aspiration pneumonia is a common cause of death in people with Parkinson’s disease (PD). Dysfunctional swallowing occurs in the majority of people with PD, and research has shown that cough function is also impaired. Previous studies suggest that testing reflex cough by having participants inhale a cough-inducing stimulus through a nebulizer may be a reliable indicator of swallowing dysfunction, or dysphagia. The primary goal of this study was to determine the cough response to two different cough-inducing stimuli in people with and without PD. The second goal of this study was to compare the co...
Source: Dysphagia - October 23, 2015 Category: Speech Therapy Source Type: research

Clinical Variables Associated with Hydration Status in Acute Ischemic Stroke Patients with Dysphagia
This study examined clinical factors that might impact hydration status in acute ischemic stroke patients with dysphagia. A retrospective chart review was completed on 67 ischemic stroke patients who participated in a prior study of nutrition and hydration status during acute care. Prior results indicated that patients with dysphagia demonstrated elevated BUN/Cr compared to non-dysphagia cases during acute care and that BUN/Cr increased selectively in dysphagic patients. This chart review evaluated clinical variables potentially impacting hydration status: diuretics, parenteral fluids, tube feeding, oral diet, and nonoral ...
Source: Dysphagia - October 23, 2015 Category: Speech Therapy Source Type: research

Videofluoroscopic Predictors of Penetration–Aspiration in Parkinson’s Disease Patients
Abstract Parkinson’s disease (PD) patients show a high prevalence of swallowing disorders and tracheal aspiration of food. The videofluoroscopic study of swallowing (VFSS) allows clinicians to visualize the visuoperceptual and temporal parameters associated with swallowing disorders in an attempt to predict aspiration risk. However, this subject remains understudied in PD populations. Our aim was to identify the predictors of penetration–aspiration in PD patients using the VFSS. Consecutive patients were evaluated using VFSS with different consistencies and volumes of food. A speech-language pathologis...
Source: Dysphagia - October 22, 2015 Category: Speech Therapy Source Type: research

Compensatory Mechanisms in Patients After a Partial or Total Glossectomy due to Oral Cancer
Abstract Excision of a part or the whole of tongue due to oral cancer disturbs swallowing and speech. Lower airways aspiration of the swallowed bolus in patients after such oral structures excision is a symptom of major swallowing disorder and may be the cause of aspiration pneumonia. Restoration of oral nutrition is possible after exclusion or reduction of aspiration threat in the patients. Video fluoroscopic evaluation of the swallowing performed at the beginning of the swallowing rehabilitation in 95 patients after a total or partial glossectomy due to oral cancer, who assessed their saliva swallowing as effici...
Source: Dysphagia - October 20, 2015 Category: Speech Therapy Source Type: research

Usefulness of Prophylactic Percutaneous Gastrostomy Placement in Patients with Head and Neck Cancer Treated with Chemoradiotherapy
Abstract Chemoradiotherapy (CRT) has evolved as the preferred organ preservation strategy in the treatment of locally advanced head and neck cancer (HNC). This approach increases malnutrition, and thus, establishing a direct enteral feeding route is essential. To evaluate the usefulness of prophylactic percutaneous endoscopic gastrostomy (PEG) in HNC patients receiving definitive CRT, we performed a prospective evaluation of HNC patients over a 6-month period. Patients and tumor characteristics, nutritional status 30 days after PEG insertion and technique complications were evaluated. We also assessed the lon...
Source: Dysphagia - October 20, 2015 Category: Speech Therapy Source Type: research

New Swallowing Evaluation Using Piezoelectricity in Normal Individuals
This study aimed to elucidate the relationship between the piezoelectric waveform latency, hyoid bone movement, surface electromyogram (sEMG), and the pharyngeal transit time (PTT) during swallowing. Forty-one healthy subjects were divided into three age groups: younger (20–39 years, n = 8), middle-aged (40–59 years, n = 9), and older (60–79 years, n = 24). Motion analysis of the hyoid bone using videofluorography (VF), waveform analysis of the front neck using piezoelectric films, and sEMG of the suprahyoid muscle group were performed simultaneously. Latencies...
Source: Dysphagia - October 20, 2015 Category: Speech Therapy Source Type: research

Electromyography of Swallowing with Fine Wire Intramuscular Electrodes in Healthy Human: Amplitude Difference of Selected Hyoid Muscles
We examined selected hyoid muscles using fine wire intramuscular electromyography (EMG) during swallowing of four food consistencies. Thirteen healthy adults were studied using videofluorography and EMG of the anterior belly of digastric (ABD), geniohyoid (GH), sternohyoid (SH), and masseter (MA; surface electrodes) while ingesting thin liquid (three trials) and solid food of three consistencies (banana, tofu, and cookie, three trials each). After rectification, integration, and normalization, peak EMG amplitudes for each muscle in each trial were measured. Hyoid displacements were measured in two dimensions. Data were ana...
Source: Dysphagia - October 20, 2015 Category: Speech Therapy Source Type: research

Swallowing Disorders in Sjögren’s Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life
Abstract This epidemiological investigation examined the prevalence, risk factors, and quality-of-life effects of swallowing disorders in Sjögren’s syndrome (SS). One hundred and one individuals with primary or secondary SS (94 females, 7 males; mean age 59.4, SD = 14.1) were interviewed regarding the presence, nature, and impact of swallowing disorders and symptoms. Associations among swallowing disorders and symptoms, select medical and social history factors, SS disease severity, and the M.D. Anderson Dysphagia Inventory (MDADI) and Short Form 36 Health Survey (SF-36) were examined. The pre...
Source: Dysphagia - October 19, 2015 Category: Speech Therapy Source Type: research

The Recline Exercise: Comparisons with the Head Lift Exercise in Healthy Adults
Abstract The aim of this investigation was to examine the comparative effectiveness of the new Recline Exercise (RE) and the traditional Head Lift Exercise (Shaker Exercise) on submental muscle activity, tongue strength, and perceived exertion in 40 healthy young adults (mean age = 24.5 years, SD 2.6 years). Both groups participated in a 6-week exercise regimen. Outcome variables evaluated pre- and post-exercise included: duration and peak amplitude of submental muscle activity during swallowing measured via surface electromyography (sEMG); anterior and posterior isometric lingual pressures mea...
Source: Dysphagia - September 19, 2015 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - September 16, 2015 Category: Speech Therapy Source Type: research

A Biomechanical Study of Hyoid Bone and Laryngeal Movements During Swallowing Comparing the Blom Low Profile Voice Inner Cannula and Passy-Muir One Way Tracheotomy Tube Speaking Valves
Abstract The aim of this prospective, consecutive, cohort study was to investigate the biomechanical effects, if any, of the Blom low profile voice inner cannula and Passy-Muir one-way tracheotomy tube speaking valves on movement of the hyoid bone and larynx during swallowing. Ten adult patients (8 male, 2 female) with an age range of 61–89 years (mean 71 years) participated. Criteria for inclusion were ≥18 years of age, English speaking, and ability to tolerate both changing to a Blom tracheotomy tube and placement of a one-way tracheotomy tube speaking valve with a fully deflated tracheot...
Source: Dysphagia - September 16, 2015 Category: Speech Therapy Source Type: research

Relationships Among Rheological, Sensory Texture, and Swallowing Pressure Measurements of Hydrocolloid-Thickened Fluids
The objective of this study was to examine the relationships among three categories of measurements (rheological, sensory texture, and swallowing pressure) from fluids thickened to two different viscosities with 15 different hydrocolloids. Fluids at viscosities of 300 and 1500 cP (at 30 s−1) were targeted because these are the viscosities corresponding to the barium standards used in radiographic dysphagia diagnosis. Within the low viscosity (nectar) fluids (300 cP), the sensory properties thickness, stickiness, adhesiveness, mouth coating, and number of swallows were highly positively correlated with ...
Source: Dysphagia - August 20, 2015 Category: Speech Therapy Source Type: research

The Physiologic Impact of Unilateral Recurrent Laryngeal Nerve (RLN) Lesion on Infant Oropharyngeal and Esophageal Performance
Abstract Recurrent laryngeal nerve (RLN) injury in neonates, a complication of patent ductus arteriosus corrective surgery, leads to aspiration and swallowing complications. Severity of symptoms and prognosis for recovery are variable. We transected the RLN unilaterally in an infant mammalian animal model to characterize the degree and variability of dysphagia in a controlled experimental setting. We tested the hypotheses that (1) both airway protection and esophageal function would be compromised by lesion, (2) given our design, variability between multiple post-lesion trials would be minimal, and (3) variability...
Source: Dysphagia - August 19, 2015 Category: Speech Therapy Source Type: research

Electrophysiological Investigations of Shape and Reproducibility of Oropharyngeal Swallowing: Interaction with Bolus Volume and Age
We describe a new approach to the electrophysiological study of swallowing based on computed semi-automatic analyses. Our findings provide insight into some previously uninvestigated aspects of oropharyngeal swallowing physiology, considered in relation to bolus volume and age. The new electrophysiological measures here described could prove useful in the clinical setting, as it is likely that they could be differently affected in patients with different kinds of dysphagia. (Source: Dysphagia)
Source: Dysphagia - August 14, 2015 Category: Speech Therapy Source Type: research

The Feasibility and Outcome of Oro-esophageal Tube Feeding in Patients with Various Etiologies
Abstract The oro-esophageal tube (OE tube) is widely used in dysphagia patients although its success rate for transition to oral feeding is reported only in stroke patients. The aim of this study was to evaluate the feasibility and outcome of OE tube feeding for patients with dysphagia resulting from various etiologies. The authors reviewed the medical records of 1995 dysphagic patients that had undergone videofluoroscopic swallowing study (VFSS) in a tertiary hospital from April 2002 through December 2009. Of these, 97 patients were recommended to use OE tube feeding based on the VFSS findings. Follow-up VFSS wer...
Source: Dysphagia - August 13, 2015 Category: Speech Therapy Source Type: research

Evaluation of swallowing function after supracricoid laryngectomy as a primary or salvage procedure
Abstract The primary functional issues following conservative therapy for advanced laryngeal cancer concern swallowing. Here, we evaluated the recovery of swallowing after supracricoid partial laryngectomy (SCL) in patients with primary or recurrent laryngeal cancer. We evaluated the swallowing recovery in 27 SCL patients through oropharyngoesophageal scintigraphy, and we evaluated their quality of life using EORTC questionnaires. Four patients underwent total laryngectomy during follow-up. Patients who retained their larynges were able to feed without nutritional support and without tracheostoma. The only signifi...
Source: Dysphagia - August 13, 2015 Category: Speech Therapy Source Type: research

Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration
In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15...
Source: Dysphagia - August 12, 2015 Category: Speech Therapy Source Type: research

Propagation Curve and Velocity of Swallowing Pressure in Healthy Young Adults
The objective of this study is to construct a propagation curve and determine propagation velocities in young healthy adults examined using a 2.64-mm-diameter high-resolution manometry catheter with 36 circumferential sensors; to explore data reproducibility; and to determine whether the swallowing pressure (SP) propagation velocity correlated with bolus volume. Repeated measures with subjects serving as their own controls. Thirty healthy subjects (average age 25.3 years) swallowed saliva and 2, 5, and 10 mL of cold water to determine the maximum SP from the soft palate to the cervical esophagus. The SP propagati...
Source: Dysphagia - August 7, 2015 Category: Speech Therapy Source Type: research

Dysphagia Research Society Annual Meeting and Post-Graduate Course
(Source: Dysphagia)
Source: Dysphagia - August 1, 2015 Category: Speech Therapy Source Type: research

Identifying Patterns of FEES-Derived Swallowing Trajectories Using Group-Based Trajectory Model
Abstract The present study delineates and visualizes swallowing trajectories along seven swallow trials in dysphagic patients using group-based trajectory modeling (GBTM). This model facilitates the recognition of swallowing functional categories, estimates their frequency of occurrence, and enhances the understanding of swallowing dynamics. Two hundred and five dysphagic patients underwent a standardized FEES examination protocol. Five ordinal variables were blindly assessed for each swallow by two observers independently. GBTM analysis was conducted to find and characterize trajectories of FEES responses. For mo...
Source: Dysphagia - July 25, 2015 Category: Speech Therapy Source Type: research

Hypersialorrhea in Wilson’s Disease
This study confirmed the hypothesis of a multifactorial origin of hypersialorrhea in patients who have been diagnosed in Wilson’s disease. It was essential to evaluate drooling with a multidisciplinary consultation to better identify the underlying mechanisms and to implement strategies for speech therapy and therapeutic adaptation. (Source: Dysphagia)
Source: Dysphagia - July 25, 2015 Category: Speech Therapy Source Type: research

Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia
Abstract We evaluated the prevalence of difficulties swallowing solid dosage forms in patients with stroke-induced dysphagia and whether swallowing tablets/capsules increases their risk of penetration and aspiration. Concurrently, we explored whether routinely performed assessment tests help identify patients at risk. Using video endoscopy, we evaluated how 52 patients swallowed four different placebos (round, oval, and oblong tablets and a capsule) with texture-modified water (TMW, pudding consistency) and milk and rated their swallowing performance according to the Penetration Aspiration Scale (PAS). Additionall...
Source: Dysphagia - July 24, 2015 Category: Speech Therapy Source Type: research

Esophageal Involvement in Multiple System Atrophy
Abstract The prevalence of esophageal involvement and its impact on clinical manifestations in patients with multiple system atrophy (MSA) remains unknown. We recruited 16 consecutive patients with dysphagia associated with MSA (MSA group) and 16 consecutive patients with dysphagia associated with amyotrophic lateral sclerosis (ALS group). We assessed the presence or absence of food stagnation within the esophagus using videofluorography. Food stagnation within the esophagus was observed in 16 patients (100 %; 7 severe, 9 mild) in the MSA group and in 4 patients (25 %; 4 mild) in the ALS group (P 
Source: Dysphagia - July 24, 2015 Category: Speech Therapy Source Type: research

Speech Pathology Reliability for Stroke Swallowing Screening Items
This study examined speech-language pathologists’ (SLPs) reliability in interpreting screening items. Swallowing screening was completed in 75 individuals admitted with stroke symptoms. Screening items evaluated were lethargy, dysarthria, wet voice unrelated to swallowing, abnormal volitional cough, and cough, throat clear, wet voice after swallowing, and inability to continuously drink with ingestion of 5 and 90 ml water. Two SLPs, each with more than 10 years of experience, made simultaneous independent judgments of the same observations obtained from the screening. Overall, generally high agreement was i...
Source: Dysphagia - July 24, 2015 Category: Speech Therapy Source Type: research

Letter to the Editor
(Source: Dysphagia)
Source: Dysphagia - July 24, 2015 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - July 16, 2015 Category: Speech Therapy Source Type: research

Effects of Age and Bolus Volume on Velocity of Hyolaryngeal Excursion in Healthy Adults
This study evaluated the effects of age and bolus volume on the velocity of hyoid and laryngeal excursion during swallowing in healthy adults. Forty-four healthy volunteers were grouped into three age bands (young: 20–35 years, middle age: 36–55 years, older: 56 ≥ years). All subjects swallowed 5 and 20 mL of thin liquid during fluoroscopic recording. Fluoroscopic images were extracted for each swallow representing the onset and maximum excursion positions of the hyoid and larynx. Superior and anterior excursion distance (excursion magnitude) and the time difference between rest and ...
Source: Dysphagia - July 11, 2015 Category: Speech Therapy Source Type: research

The Effect of Bolus Consistency and Sex on Electrophysiological Measures of Hyolaryngeal Muscle Activity During Swallowing
Abstract The purpose of this study was to investigate the effect of bolus consistency and sex on the activity of the submandibular hyolaryngeal muscles during swallowing. Twenty young, healthy adults (10 males, 10 females) swallowed four types of bolus material (thin liquid, thick liquid, pudding, and cookie) while being measured with surface electromyography. Measurements of peak contraction amplitude and contraction duration were computed from recorded electromyographic signals. Results from statistical analyses revealed a significant effect of bolus consistency on measures of peak contraction amplitude, but not...
Source: Dysphagia - July 9, 2015 Category: Speech Therapy Source Type: research

Dysphagia Caused by Chronic Laryngeal Edema
Abstract A rare case of a young female with chronic diffuse laryngeal edema causing severe swallowing difficulty is presented. The patient was previously treated with antibiotics and steroids with no improvement. Diagnosis was made with biopsy of the epiglottis under local anesthesia in the office. (Source: Dysphagia)
Source: Dysphagia - July 7, 2015 Category: Speech Therapy Source Type: research