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Erratum to: Decreased Tongue Pressure is Associated with Sarcopenia and Sarcopenic Dysphagia in the Elderly
(Source: Dysphagia)
Source: Dysphagia - November 8, 2014 Category: Speech Therapy Source Type: research

Influence of the Chin-Down and Chin-Tuck Maneuver on the Swallowing Kinematics of Healthy Adults
Abstract The purpose of the study was to investigate the influence of the chin-tuck maneuver on the movements of swallowing-related structures in healthy subjects and formulate standard instructions for the maneuver. A total of 40 healthy volunteers (20 men and 20 women) swallowed 10 mL of diluted barium solution in a “normal and comfortable” position (NEUT), a comfortable chin-down position (DOWN), and a strict chin-tuck position (TUCK). Resting state anatomy and kinematic changes were analyzed and compared between postures. Although angles of anterior cervical flexion were comparable between DOW...
Source: Dysphagia - October 31, 2014 Category: Speech Therapy Source Type: research

Dysphagia Research Society Annual Meeting and Post-Graduate Course
(Source: Dysphagia)
Source: Dysphagia - October 30, 2014 Category: Speech Therapy Source Type: research

The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review
Abstract Texture modification has become one of the most common forms of intervention for dysphagia, and is widely considered important for promoting safe and efficient swallowing. However, to date, there is no single convention with respect to the terminology used to describe levels of liquid thickening or food texture modification for clinical use. As a first step toward building a common taxonomy, a systematic review was undertaken to identify empirical evidence describing the impact of liquid consistency and food texture on swallowing behavior. A multi-engine search yielded 10,147 non-duplicate articles, which...
Source: Dysphagia - October 25, 2014 Category: Speech Therapy Source Type: research

Physical Properties of Root Crops Treated with Novel Softening Technology Capable of Retaining the Shape, Color, and Nutritional Value of Foods
Abstract Hard, difficult-to-eat root crops (carrots and burdock roots) were homogeneously softened by an enzyme permeation method so that they could be mashed easily by the tongue while retaining appearance, flavor, and nutrients. The appearance, color, and nutritional value of these foods were equivalent to those of normally cooked root crops of the same type. The firmness of the softened root crops was at least 100 times as low as normally cooked root crops and lower than some care food products for patients with swallowing disorders. Compared with control root crops, which were treated with a freeze–...
Source: Dysphagia - October 25, 2014 Category: Speech Therapy Source Type: research

The Diagnosis of Esophageal Eosinophilia is Not Increased in the Summer Months
Abstract Smaller studies have suggested seasonal variation of the diagnosis of eosinophilic esophagitis with more patients being diagnosed in the aeroallergen season. We evaluated a large group of adult patients for a seasonal variation of the diagnosis of symptomatic eosinophilic esophageal infiltration. We performed a retrospective review of adult patients from a large Eosinophilic esophagitis database at the Mayo Clinic Rochester. We only included patients from three states in the upper Midwest, who had 15 or more eosinophils per high-power field on esophageal biopsy, symptomatic dysphagia, and were seen, i...
Source: Dysphagia - October 7, 2014 Category: Speech Therapy Source Type: research

A Systematic Review of Self-reported Swallowing Assessments in Progressive Neurological Disorders
Abstract Dysphagia experienced as a consequence of neurodegenerative disease can have severe consequences on a patient’s health and well-being. Regular assessment of swallowing function can assist to achieve adequate nutrition and hydration. Here we review subjective swallowing assessments currently available are suitable for use in people with neurodegenerative disease. Measurement properties were reviewed for each tool and coverage of the World Health Organization’s International Classification of Functioning, Disability and Health (WHO ICF) was considered. Assessments were identified following a rev...
Source: Dysphagia - October 3, 2014 Category: Speech Therapy Source Type: research

The Effect of Bilateral Superior Laryngeal Nerve Lesion on Swallowing: A Novel Method to Quantitate Aspirated Volume and Pharyngeal Threshold in Videofluoroscopy
Abstract The purpose was to determine the effect of bilateral superior laryngeal nerve (SLN) lesion on swallowing threshold volume and the occurrence of aspiration, using a novel measurement technique for videofluoroscopic swallowing studies (VFSS) in infant pigs. We used a novel radiographic phantom to assess volume of the milk containing barium from fluoroscopy. The custom made phantom was firstly calibrated by comparing image intensity of the phantom with known cylinder depths. Secondly, known volume pouches of milk in a pig cadaver were compared to volumes calculated with the phantom. Using these standards, we...
Source: Dysphagia - October 1, 2014 Category: Speech Therapy Source Type: research

Training Effects of the Effortful Swallow Under Three Exercise Conditions
This study examined how high-effort sips from small-diameter straws influenced linguapalatal swallow pressures. Additionally, training effects of effortful swallows preceded by high-effort sips were compared to two other exercise conditions: effortful swallows preceded by maximum effort lingual elevation and effortful swallows performed in isolation. Training outcomes included linguapalatal pressures produced during effortful and noneffortful swallows, and maximum isometric pressure (MIP) produced during tongue elevation and interlabial compression. Forty healthy adults participated in the experiment. Lingual–palatal...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Correlation Varies with Different Time Lags Between the Motions of the Hyoid Bone, Epiglottis, and Larynx during Swallowing
This study aimed to apply a cross-correlation analysis of the motions of the hyolaryngeal structures during swallowing as an objective method for measuring the coordination and timing of the motions. Forty healthy subjects swallowed 2 and 5 ml of diluted barium solution (35 %) and 5 ml of curd yogurt under videofluoroscopy. Hyolaryngeal motions in videofluoroscopic images were digitized using the motion analysis system. The time series of the horizontal and vertical hyoid motion, the laryngeal elevation, and the angle of the epiglottic tilt were analyzed using cross-correlation at each 1/60-s time lag. The r...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

The Normative Range for and Age and Gender Effects on the Sydney Swallow Questionnaire (SSQ)
Abstract The Sydney Swallow Questionnaire (SSQ) is a validated measure of the symptomatic severity of oral–pharyngeal dysphagia. Up until now no normative ranges have been established for the questionnaire. This is a limitation in its utility as it makes it difficult to use the tool to identify the prevalence and burden of oral–pharyngeal dysphagia in the general population or within patient populations. The study’s aim was to derive the normative range of dysphagia scores for the SSQ and to determine whether, in nondysphagic individuals, there are any age or gender effects on these scores. The ...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Automated Acoustic Analysis in Detection of Spontaneous Swallows in Parkinson’s Disease
In this study, a noninvasive automated technique is proposed that uses breath and swallowing recordings obtained via a microphone located over the laryngopharynx. Nonlinear diffusion filters were used in which a scale-space decomposition of recorded sound at different levels extract swallows from breath sounds and artifacts. This technique was compared to manual detection of swallows using acoustic signals on a sample of 34 subjects with Parkinson’s disease. A speech language pathologist identified five subjects who showed aspiration during the videofluoroscopic swallowing study. The proposed automated method identif...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Chin Tuck for Prevention of Aspiration: Effectiveness and Appropriate Posture
This study was performed to investigate the effectiveness and the degree of optimal neck flexion of chin tuck. Ninety-seven patients who showed aspiration in the videofluoroscopic swallow study (VFSS). Participants were grouped into the effective (patients who showed effect with chin tuck) and ineffective group (those who did not show effect with chin tuck). VFSS was performed in neutral and chin tuck position and findings were compared between the groups. Severity of aspiration was assessed by the point penetration-aspiration scale. Duration of dysphagic symptoms, history of tracheostomy, and other possible contributing f...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

FEES Protocol Derived Estimates of Sensitivity: Aspiration in Dysphagic Patients
The objective of this prospective study was to determine the FEES protocol derived estimates of sensitivity (Se′) to detection of aspiration in dysphagic patients. The study estimated the probability of aspiration as a function of the number of swallow trials in dysphagic patients using FEES. The derived sensitivity was calculated based on presence or absence of aspiration in a ten-swallow trial protocol as arbitrary ‘gold standard’. Eighty-four persons were included, comprising two patient populations with oropharyngeal dysphagia. Dysphagia in one group was due to head and neck cancer and possible oncolo...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Oral Care May Reduce Pneumonia in the Tube-fed Elderly: A Preliminary Study
In conclusion, the results of the present study suggest that daily oral care for tube-fed patients who do not receive nutrition by mouth reduced the incidence of pneumonia. In addition to patients consuming food by mouth, all tube-fed patients require dedicated oral care to maintain healthy oral conditions. (Source: Dysphagia)
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

The One-Year Attributable Cost of Post-stroke Dysphagia
This study sought to address this issue by examining the 1-year cost associated with a diagnosis of dysphagia post-stroke in South Carolina. Furthermore, this study investigated whether ethnicity and residence differences exist in the cost of dysphagia post-stroke. Data on 3,200 patients in the South Carolina Medicare database from 2004 who had ICD-9 codes for ischemic stroke, 434 and 436, were retrospectively included in this study. Differences between persons with and without dysphagia post-stroke were compared with respect to age, gender, ethnicity, mortality, length of stay, comorbidity, rurality, discharge disposition...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Quality of Life Related to Swallowing in Parkinson’s Disease
In conclusion, patients with PD have significantly lower scores in all domains of the SWAL-QOL than normal controls. This means swallowing difficulties occurring in patients with PD negatively affect their QOL. Progression of the disease worsens swallowing QOL, more specifically in the domains of eating duration, symptom frequency, and sleep. This occurs mostly at later stages of the disease. (Source: Dysphagia)
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Wet Voice as a Sign of Penetration/Aspiration in Parkinson’s Disease: Does Testing Material Matter?
Abstract Wet voice is a perceptual vocal quality that is commonly used as an indicator of penetration and/or aspiration in clinical swallowing assessments and bedside screening tests. Our aim was to describe the clinimetric characteristics of this clinical sign using various fluid materials and one solid food in the Parkinson’s disease (PD) population. Consecutive PD individuals were submitted for simultaneous fiberoptic endoscopic evaluation of swallowing (FEES) and voice recording. Speech therapists rated the presence or absence of wetness and other voice abnormalities. Two binary endpoints of FEES were s...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Evaluating the Tongue-Hold Maneuver Using High-Resolution Manometry and Electromyography
Abstract The tongue-hold maneuver is a widely used clinical technique designed to increase posterior pharyngeal wall movement in individuals with dysphagia. It is hypothesized that the tongue-hold maneuver results in increased contraction of the superior pharyngeal constrictor. However, an electromyographic study of the pharynx and tongue during the tongue-hold is still needed to understand whether and how swallow muscle activity and pressure may change with this maneuver. We tested eight healthy young participants using simultaneous intramuscular electromyography with high-resolution manometry during three task ...
Source: Dysphagia - September 27, 2014 Category: Speech Therapy Source Type: research

Evaluation of Hypopharyngeal Suction to Eliminate Aspiration: The Retro-Esophageal Suction (REScue) Catheter
Abstract Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter...
Source: Dysphagia - September 26, 2014 Category: Speech Therapy Source Type: research

Decreased Tongue Pressure is Associated with Sarcopenia and Sarcopenic Dysphagia in the Elderly
Abstract The aim of this study was to clarify the association between tongue pressure and factors related to sarcopenia such as aging, activities of daily living, nutritional state, and dysphagia. One-hundred-and-four patients without a history of treatment of stroke and without a diagnosis of neurodegenerative disease (36 men and 68 women), with a mean age of 84.1 ± 5.6 years, hospitalized from May 2013 to June 2013 were included in this study. Maximum voluntary tongue pressure against the palate (MTP) was measured by a device consisting of a disposable oral balloon probe. Nutritional and an...
Source: Dysphagia - September 24, 2014 Category: Speech Therapy Source Type: research

Occurrences of Yawn and Swallow are Temporally Related
Abstract Yawning is a stereotyped motor behavior characterized by deep inhalation and associated dilation of the respiratory tract, pronounced jaw opening, and facial grimacing. The frequency of spontaneous yawning varies over the diurnal cycle, peaking after waking and before sleep. Yawning can also be elicited by seeing or hearing another yawn, or by thinking about yawning, a phenomenon known as “contagious yawning”. Yawning is mediated by a distributed network of brainstem and supratentorial brain regions, the components of which are shared with other airway behaviors including respiration, swallowi...
Source: Dysphagia - September 21, 2014 Category: Speech Therapy Source Type: research

Submucosal Bulge in the Hypopharynx Causing Dysphagia
(Source: Dysphagia)
Source: Dysphagia - September 11, 2014 Category: Speech Therapy Source Type: research

Erratum to: Evaluating the Tongue-Hold Maneuver Using High-Resolution Manometry and Electromyography
(Source: Dysphagia)
Source: Dysphagia - August 28, 2014 Category: Speech Therapy Source Type: research

Impact of Children’s Feeding/Swallowing Problems: Validation of a New Caregiver Instrument
Abstract The impact of caring for children with deglutition disorders is poorly understood and tools to measure the unique concerns of these caregivers are lacking. The aims of this investigation were to develop and validate The Feeding/Swallowing Impact Survey (FS-IS) as an instrument designed to measure and improve understanding of caregiver issues. Demographic, economic, and dysphagic data were provided by the primary caregivers of 164 children (median age: 14 months, male: 78, female: 86) presenting for initial outpatient feeding/swallowing evaluations. Caregivers completed the PEDS-QL™ Family Impac...
Source: Dysphagia - August 27, 2014 Category: Speech Therapy Source Type: research

An Investigation into the Stability and Sterility of Citric Acid Solutions Used for Cough Reflex Testing
Abstract Citric acid is used in cough reflex testing in clinical and research settings to assess reflexive cough in patients at risk of swallowing disorders. To address a lack of knowledge in this area, this study investigated the stability and sterility of citric acid solutions. Triplicate solutions of citric acid (0.8 M) in isotonic saline were stored at 4 ± 2 °C for up to 28 days and analysed by high-performance liquid chromatography. Microbiological sterility of freshly prepared samples and bulk samples previously used for 2 weeks within the hospital was determined usin...
Source: Dysphagia - August 24, 2014 Category: Speech Therapy Source Type: research

Earliest Videofluoromanometric Pharyngeal Signs of Dysphagia in ALS Patients
Abstract The aim of this study was to find whether there are manometric pharyngeal changes that may have diagnostic and prognostic relevance in the amyotrophic lateral sclerosis (ALS) patient who does not show changes in contrast-medium oropharyngeal transit in a videofluoroscopic swallowing study. Ten ALS patients, with an ALS Severity Scale Score of at least 7, no need to change dietary habit, no aspiration and/or penetration, and no other changes in contrast-medium oropharyngeal transit, were collected from our institution’s database of videofluoromanometric swallowing studies. They were included in the s...
Source: Dysphagia - August 21, 2014 Category: Speech Therapy Source Type: research

Electromyography of Swallowing with Fine Wire Intramuscular Electrodes in Healthy Human: Activation Sequence of Selected Hyoid Muscles
We examined temporal characteristics of selected hyoid muscles using fine wire intramuscular electromyography (EMG). Thirteen healthy adults were studied using EMG of the anterior belly of digastric (ABD), geniohyoid (GH), sternohyoid (SH), and masseter (MA, with surface electrodes) while ingesting thin liquid, banana, tofu, and cookie (3 trials each). Onset timing was measured from rectified and integrated EMG. Data were analyzed using repeated-measures ANOVA with Bonferroni correction. When drinking thin liquid, MA, GH, and ABD were activated almost simultaneously, but SH was activated later (using GH onset as 0 s, ...
Source: Dysphagia - August 21, 2014 Category: Speech Therapy Source Type: research

Anatomical Considerations of the Longitudinal Pharyngeal Muscles in Relation to their Function on the Internal Surface of Pharynx
Abstract The aim of this study was to clarify the topography of the longitudinal pharyngeal muscles and to relate the findings to pharyngeal muscular function. Forty-four specimens (22 right and 22 left sides) from embalmed Korean adult cadavers (13 males, 9 females; age range, 46–89 years; mean age, 69.2 years) were used in this study. The palatopharyngeus muscle originated from the palatine aponeurosis and the median part of the soft palate on oral aspect; it ran downward and lateralward, respectively. The palatopharyngeus muscle, which held the levator veli palatini, was divided into two bundles...
Source: Dysphagia - August 21, 2014 Category: Speech Therapy Source Type: research

Frequency of Stage II Oral Transport Cycles in Healthy Human
Abstract Stage II transport (St2Tr) is propulsion of triturated food into the pharynx for storage before swallowing via tongue squeeze-back against the palate. To clarify the phenomenology of St2Tr, we examined the effects of food consistency and the number of chewing cycles on the number of St2Tr cycles in a chew-swallow sequence. We recorded chew-swallow sequences in lateral projection with videofluoroscopy of 13 healthy volunteers eating 6 g of hard (shortbread cookie), and soft foods (ripe banana and tofu) with barium. We counted the number of chewing and St2Tr cycles from food intake to terminal swal...
Source: Dysphagia - August 21, 2014 Category: Speech Therapy Source Type: research

Dysphagia and Associated Risk Factors Following Extubation in Cardiovascular Surgical Patients
Abstract Following cardiovascular (CV) surgery, prolonged mechanical ventilation of>48 h increases dysphagia frequency over tenfold: 51 % compared to 3–4 % across all durations. Our primary objective was to identify dysphagia frequency following CV surgery with respect to intubation duration. Our secondary objective was to explore characteristics associated with dysphagia across the entire sample. Using a retrospective design, we stratified all consecutive patients who underwent CV surgery in 2009 at our institution into intubation duration groups defined a priori: I (≤12 h), II (&g...
Source: Dysphagia - August 15, 2014 Category: Speech Therapy Source Type: research

Functional Swallowing Outcomes in Nasopharyngeal Cancer Treated with IMRT at 6 to 42 months Post-Radiotherapy
Abstract We sought to evaluate the swallowing function of 18 patients surviving nasopharyngeal cancer, who had been treated using an intensity-modulated radiotherapy (IMRT) protocol designed to minimise functional impairment. We compared the outcomes of a patient-reported oral function score with fiberoptic endoscopic examination of swallow (FEES), Australian Therapy Outcome Measures (AusTOMs) and a measure of trismus. While all patients returned to a fully oral diet, there was ongoing swallow dysfunction characterised by bolus residue and delay, but no aspiration. Dysphagia was of mild or moderate severity on all...
Source: Dysphagia - August 13, 2014 Category: Speech Therapy Source Type: research

Improving Post-Stroke Dysphagia Outcomes Through a Standardized and Multidisciplinary Protocol: An Exploratory Cohort Study
Abstract Stroke is a major cause of dysphagia. Few studies to date have reported on standardized multidisciplinary protocolized approaches to the management of post-stroke dysphagia. The aim of this retrospective cohort study was to evaluate the impact of a standardized multidisciplinary protocol on clinical outcomes in patients with post-stroke dysphagia. We performed retrospective chart reviews of patients with post-stroke dysphagia admitted to the neurological ward of Verona University Hospital from 2004 to 2008. Outcomes after usual treatment for dysphagia (T− group) were compared versus outcomes after t...
Source: Dysphagia - August 13, 2014 Category: Speech Therapy Source Type: research

Comments on Selected Recent Dysphagia Literature
(Source: Dysphagia)
Source: Dysphagia - August 8, 2014 Category: Speech Therapy Source Type: research

Application of the International Classification of Functioning, Disability and Health (ICF) to People with Dysphagia Following Non-surgical Head and Neck Cancer Management
Abstract The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an individual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was condu...
Source: Dysphagia - August 7, 2014 Category: Speech Therapy Source Type: research

Variations in Tongue-Palate Swallowing Pressures When Swallowing Xanthan Gum-Thickened Liquids
In this study, we measured variations in tongue-palate pressures during the swallowing of liquids thickened to apparent viscosities of 190, 250, and 380 mPa s at 50/s using increasing concentrations of xanthan gum (0.5, 0.63 and 0.87 w/w%). The viscosity differences between these nectar- and honey-thick stimuli were confirmed to exceed sensory perceptual discrimination thresholds. Data were collected from 78 healthy adults in two sex-balanced age-groups (young; mature) and compared to reference values obtained during water swallowing. The results confirm that increased amplitudes of tongue-palate pressure we...
Source: Dysphagia - August 3, 2014 Category: Speech Therapy Source Type: research

Acoustic Study of Pharyngeal Swallowing as a Function of the Volume and Consistency of the Bolus
Abstract Cervical auscultation is a noninvasive technique for the exploration of swallowing and has been used since the 1960s. The aim of our study was to describe how the volume and consistency of the bolus affect swallowing acoustic sound characteristics in healthy subjects. Twenty-three subjects aged from 20 to 59 years were included (13 women and 10 men). A microphone mounted on a stethoscope chest piece, positioned on the skin on the right side in front of the posteroinferior border of the cricoid cartilage, was used; it was connected to a computer for acoustic recordings. Each subject swallowed 2-, 5-,...
Source: Dysphagia - August 1, 2014 Category: Speech Therapy Source Type: research

Variation in the Timing and Frequency of Sucking and Swallowing over an Entire Feeding Session in the Infant Pig Sus scrofa
Abstract Feeding is a rhythmic behavior that consists of several component cycle types. How the timing of these cycles changes over a complete feeding sequence is not well known. To test the hypothesis that cycle frequency/duration changes as a function of time spent feeding, we examined complete feeding sequences in six infant pigs, using EMG of mylohyoid and thyrohyoid as cycle markers. We measured the instantaneous frequency of sucking and of swallowing cycles in 19 sequences. Each sequence contained three qualitatively distinctive phases of sucking frequency. Phase 1 started with cycles at a very high frequen...
Source: Dysphagia - August 1, 2014 Category: Speech Therapy Source Type: research

Differences in Videofluoroscopic Swallowing Study (VFSS) Findings According to the Vascular Territory Involved in Stroke
Abstract Dysphagia affects up to half of stroke patients and increases the risk of pneumonia and fatal outcomes. In order to assess swallowing difficulty, videofluoroscopic swallowing study (VFSS) has traditionally been the gold standard. The purpose of this study was to compare the patterns of post-stroke swallowing difficulties according to the vascular territories involved in the stroke. One hundred and three patients who were diagnosed with first ischemic stroke by brain magnetic resonance imaging and had swallowing difficulty were included in this study. Location of the stroke was classified into three group...
Source: Dysphagia - August 1, 2014 Category: Speech Therapy Source Type: research

An Unusual Case of Dysphagia in a Child
(Source: Dysphagia)
Source: Dysphagia - August 1, 2014 Category: Speech Therapy Source Type: research