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The Mayo Dysphagia Questionnaire-30: Documentation of Reliability and Validity of a Tool for Interventional Trials in Adults with Esophageal Diseaseemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The aim of this study was to develop the Mayo Dysphagia Questionnaire-30 Day (MDQ-30), a tool to measure esophageal dysphagia, by adapting items from validated instruments for use in clinical trials, and assess its feasibility, reproducibility, and concurrent validity. Outpatients referred to endoscopy for dysphagia or seen in a specialty clinic were recruited. Feasibility testing was done to identify problematic items. Reproducibility was measured by test–retest format. Concurrent validity reflects agreement between information gathered in a structured interview versus the patients’ written res...
Source: Dysphagia - October 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic Patientsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Oropharyngeal dysphagia is frequent in stroke patients and increases mortality, mainly because of pulmonary complications. We hypothesized that sensitive transcutaneous electrical stimulation applied submentally during swallowing could help rehabilitate post-stroke oropharyngeal dysphagia by improving cortical sensory motor circuits. Eleven patients were recruited for the study (5 females, 68 ± 11 years). They all suffered from recent oropharyngeal dysphagia (>eight weeks) induced by a hemispheric (n = 7) or brainstem (n = 4) stroke, with pharyngeal residue and...
Source: Dysphagia - October 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Computer-Assisted Assessment of Hyoid Bone Motion from Videofluoroscopic Swallow Studiesemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We describe a computerized image analysis program designed to objectify one component of the swallow study, the movement of the hyoid bone. Hyoid motion has been shown to be different in dysphagic versus non-dysphagic patients. Reduced hyoid elevation is also considered a risk factor for aspiration; however, there has not been much work done on actually quantifying hyoid motion and associating it with other aspects of the swallow study. The clinician is prompted to define the hyoid bone in a calibration frame, and the system then tracks that region of interest throughout the rest of the study. This system shows strong...
Source: Dysphagia - October 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Fluoroscopic Surrogate for Pharyngeal Strength: The Pharyngeal Constriction Ratio (PCR)email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
The objective of the current study was to evaluate the correlation between PCR and PP in 25 patients undergoing simultaneous fluoroscopy and pharyngeal manometry. The effect of the manometric catheter on PCR was also investigated. The correlation between the PCR and averaged pharyngeal clearing pressures was −0.72 (p < 0.001). All patients with a PCR > 0.25 had a PP < 60 mmHg. PCR did not differ significantly as a consequence of the manometric catheter. Results suggest the utility of an objective fluoroscopic measure in assessing pharyngeal strength when manometry may not ...
Source: Dysphagia - October 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Gender Effects on Airway Closure in Head and Neck Cancer Patientsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Age, gender, and bolus effects on the duration of laryngeal closure, the onset of laryngeal closure in relation to the first cricopharyngeal opening, and the duration of cricopharyngeal opening in head and neck cancer patients have not been well documented. Thirty-three head and neck cancer patients (middle-aged women and men, and older women and men) were evaluated with videofluoroscopy before and 3 months after their cancer treatment. At 3 months post-treatment, the mean duration of laryngeal closure was longer for women than for men at 1-, 5-, and 10-ml bolus volumes. The duration of la...
Source: Dysphagia - October 22, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Dysphagia Research Societyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory AbstractsDOI 10.1007/s00455-009-9234-z Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)
Source: Dysphagia - September 30, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Severe Dysphagia Secondary to Posterior C1–C3 Instrumentation in a Patient with Atlantoaxial Traumatic Injury: A Case Report and Review of the Literatureemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  There are only a few reports of dysphagia cases in patients who underwent surgery for posterior cervical fusion, but none provides an explanation for the occurrence of dysphagia. To the best of our knowledge this is the first case report showing evidence of severe neurogenic dysphagia, possibly secondary to vagal nerve praxia, in a patient who underwent posterior fusion. A 61-year-old man presented with severe neck pain after he sustained a fall. Imaging studies in the emergency department showed a C2 fracture associated with anterior subluxation of C2 on C3. Given the instability of the injury, a C...
Source: Dysphagia - September 30, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Dysphagia Research Societyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory AbstractsDOI 10.1007/s00455-009-9233-0 Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)
Source: Dysphagia - September 30, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Primary Tuberculosis Involving Epiglottis: A Rare Case Reportemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The case of a 29-year-old patient with active laryngeal tuberculosis predominantly involving the epiglottis, without pulmonary disease, is presented. The predominant symptoms are dysphagia, odynophagia, and hoarseness. Laryngeal carcinoma, which shares almost the same symptoms and signs, should be ruled out immediately. Laryngeal tuberculosis is discussed with a brief literature review. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00455-009-9256-6Authors Deniz Tuna Edizer, Istanbul University Otorhinolaryngology Department, Cerrahpasa Medical School Istanbul TurkeyEmin Karaman, I...
Source: Dysphagia - September 29, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Gender Effects on Airway Closure in Normal Subjectsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The present study was designed to examine age and gender differences with respect to the duration of laryngeal closure, the onset of laryngeal closure in relation to the first cricopharyngeal opening, and the duration of cricopharyngeal opening for six different groups: normal younger men and women (22–29 years), normal middle-aged men and women (45–53 years), and normal older men and women (81–94 years) (10 subjects in each group for a total of 60 subjects). Data were collected by means of videofluoroscopic studies. During swallows of liquid barium, results indicated that norma...
Source: Dysphagia - September 29, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Symptomatic Unilateral Submandibular Gland Aplasia Associated with Ipsilateral Sublingual Gland Hypertrophyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00455-009-9238-8Authors Mehmet Yilmaz, Istanbul University Department of Otorhinolaryngology, Cerrahpasa Medical School Istanbul TurkeyEmin Karaman, Istanbul University Department of Otorhinolaryngology, Cerrahpasa Medical School Istanbul TurkeyHuseyin Isildak, Istanbul University Department of Otorhinolaryngology, Cerrahpasa Medical School Istanbul TurkeyOzgun Enver, Istanbul University Department of Otorhinolaryngology, Cerrahpasa Medical School Istanbul TurkeyFahrettin Kilic, Istanbul University Department of Radiology, Cerrahpasa Medical School Istanbul T...
Source: Dysphagia - September 25, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Oropharyngeal Dysphagia in Infants and Children with Infantile Pompe Diseaseemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Pompe disease is a rare genetic progressive neuromuscular disorder. The most severe form, infantile Pompe disease, has historically resulted in early mortality, most commonly due to cardiorespiratory failure. Treatment with enzyme replacement therapy (ERT) using alglucosidase alfa (Myozyme®) has extended the lifespan of individuals with this disease. With the introduction of ERT and the resultant improved survival, dysphagia is being encountered clinically with increasing regularity though systematic data remain unavailable. We retrospectively studied the oropharyngeal swallowing of 13 infants and ...
Source: Dysphagia - September 17, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Long-Term Results of External Upper Esophageal Sphincter Myotomy for Oropharyngeal Dysphagiaemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The aim of this work was to assess the efficacy of external myotomy of the upper esophageal sphincter (UES) for oropharyngeal dysphagia. In the period 1991–2006, 28 patients with longstanding dysphagia and/or aspiration problems of different etiologies underwent UES myotomy as a single surgical treatment. The main symptoms were difficulties in swallowing of a solid-food bolus, aspiration, and recurrent incidents of solid-food blockages. Pre- and postoperative manometry and videofluoroscopy were used to assess deglutition and aspiration. Outcome was defined as success in the case of complete relief...
Source: Dysphagia - September 17, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Age-Related Differences in Laterality of Cortical Activations in Swallowingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The present study examined age differences in neural lateralization patterns during swallowing and three related tasks, using functional magnetic resonance imaging (fMRI). Ten healthy right-handed young adults (mean age = 21.7 years, SD = 2.1 years) and nine healthy elders (mean age = 70.2 years, SD = 3.9 years) were scanned in a 3-T MRI head scanner. Participants were visually cued to “prepare to swallow,” “swallow,” “tap your tongue,” and “clear your throat” in randomized order. Laterality preference for each task was exam...
Source: Dysphagia - September 17, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Laryngeal Mass with Multiple Cranial Neuropathies as a Presenting Sign for Varicella Zoster Infectionemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The most common presentation of varicella zoster virus (VZV) infection is unilateral distribution of herpetic eruptions and neuralgia. Laryngeal involvement is considered very rare. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00455-009-9254-8Authors Rabia Shihada, Technion - Israel Institute of Technology Department of Otolaryngology - Head and Neck Surgery, Bnai-Zion Medical Center P.O. Box 4940 31048 Haifa IsraelAlexander Brodsky, Technion - Israel Institute of Technology Department of Otolaryngology - Head and Neck Surgery, Bnai-Zion Medical Center P.O. Box 4940 31048 Haifa Isr...
Source: Dysphagia - September 17, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Effects of Therapy in Oropharyngeal Dysphagia by Speech and Language Therapists: A Systematic Reviewemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Medical and paramedical treatments should be evaluated according to current standards of evidence-based medicine. Evaluation of therapy in oropharyngeal dysphagia fits into this growing interest. A systematic review is given of the literature on the effects of therapy in oropharyngeal dysphagia carried out by speech therapists. Thus, the review excludes reports of surgical or pharmacological treatments. The literature search was performed using the electronic databases PubMed and Embase. All available inclusion dates up to November 2008 were used. The search was limited to English, German, French, S...
Source: Dysphagia - September 17, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Initiation and Duration of Laryngeal Closure During the Pharyngeal Swallow in Post-Stroke Patientsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  As a bolus enters the pharynx during the swallow, the airway is protected by laryngeal closure, a process characterized by approximation of the vocal folds plus approximation of the arytenoid cartilages to the base of the epiglottis. The purpose of this study was to measure initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) in three groups of subjects: (1) ten stroke patients who aspirated before and during the swallow (aspirators), (2) ten stroke patients who did not aspirate (nonaspirators), and (3) ten normal control subjects. Means and standard deviations of ILC and LCD w...
Source: Dysphagia - September 17, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Supranuclear Control of Swallowingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Swallowing is an act requiring complex sensorimotor integration. Using a variety of methods first used to study limb physiology, initial efforts to study swallowing have yielded information that multiple cortical and subcortical regions are active participants. Not surprisingly, the regions activated appear to overlap those involved in both oral and nonoral motor behaviors. This review offers a perspective that considers the supranuclear control of swallowing in light of these physiological similarities. Content Type Journal ArticleCategory Review ArticleDOI 10.1007/s00455-009-9249-5Authors Norm...
Source: Dysphagia - September 15, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

2009 Dysphagia Research Society President’s Report: Dysphagia Week Declared in New Orleans for the 17th Annual DRS Meetingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory EditorialDOI 10.1007/s00455-009-9253-9Authors Benson T. Massey, Medical College of Wisconsin Division of Gastroenterology and Hepatology 9200 West Wisconsin Avenue Milwaukee WI 53226 USA Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)
Source: Dysphagia - September 3, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Esophageal Complications Following Aluminium Phosphide Ingestion: An Emerging Issue Among Survivors of Poisoningemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Aluminium phosphide ingestion is the most common agricultural poisoning in suburban and rural India and with a high mortality rate. Among survivors of acute poisoning there are recent sporadic reports of esophageal complications such as esophageal strictures and tracheo-esophageal fistula. The present study was carried out to determine the incidence, natural history, and treatment outcome of local esophageal complications in survivors of aluminium phosphide poisoning with complaints of dysphagia. All confirmed cases of poisoning with aluminium phosphide ingestion were admitted in Hamidia Hospital, G...
Source: Dysphagia - September 3, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Dysphagia in Head and Neck Cancer Patients Treated with Chemoradiotherapyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Dysphagia is a very common complaint of head and neck cancer patients and can exist before, during, and after chemoradiotherapy. It leads to nutritional deficiency, weight loss, and prolonged unnatural feeding and also has a major potential risk for aspiration. This has a significant negative impact on the patient’s entire quality of life. Because treatment of dysphagia in this setting is rarely effective, prevention is paramount. Several strategies have been developed to reduce dysphagia. These include swallowing exercises, treatment modification techniques such as intensity-modulated radiotherap...
Source: Dysphagia - August 27, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Immediate Effects of Thermal–Tactile Stimulation on Timing of Swallow in Idiopathic Parkinson’s Diseaseemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson’s disease (IPD). Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. Thermal–tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. The effects of TTS on swallowing have not yet been investigated in IPD. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a coh...
Source: Dysphagia - August 26, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Oropharyngolaryngeal Disorders in Scleroderma: Development and Validation of the SLS Scaleemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Systemic sclerosis (SSc) is a multisystemic disorder characterized by functional and structural abnormalities of small blood vessels and fibrosis of the skin and internal organs. Eighty percent of subjects with SSc have orofacial manifestations. No tests for oral manifestations have been validated for this pathology, and in the literature there are few studies of speech therapy for subjects with SSc. These facts suggested the need for an exhaustive assessment of mouth mobility and muscle strength, and also of swallowing and voice, in order to plan a targeted and effective speech therapy. The Sclerod...
Source: Dysphagia - August 26, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Disturbances of Esophageal Motility in Eosinophilic Esophagitis: A Case Seriesemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Esophageal manometry (EM) findings were reviewed in 14 (13 male) adults diagnosed with eosinophilic esophagitis (EE). One had complete nonperistaltic contractions (amplitude range = 30–180 mmHg) and incomplete relaxation of the lower esophageal sphincter (LES), suggesting vigorous achalasia. After 6 months of steroid therapy the repeat EM showed near-normal findings. One had total aperistalsis with contraction amplitudes less than 10 mmHg and a weak LES pressure (8 mmHg), criteria suggesting scleroderma. Two had low-amplitude (<30 mmHg) nonperistaltic contract...
Source: Dysphagia - August 26, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

The Effect of Lateral Shift of Cricoid Cartilage on Pharyngeal Swallowingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Head rotation is widely used as one of the postural techniques for dysphagic patients. However, it cannot be used for patients with severe limitations to the range of motion of the neck. The purpose of this study was to determine the effect of applying pressure to the cricoid while swallowing and to explore the possibility of this maneuver as an alternative to head rotation. The swallowing function of 12 volunteers was examined with videofluorography under nine conditions: neutral, head rotated to the right, head rotated to the left, applying pressure to the cricoid on the right side at 5, 10, and 1...
Source: Dysphagia - August 21, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

The Impact of Dysphagia on Quality of Life in Ageing and Parkinson’s Disease as Measured by the Swallowing Quality of Life (SWAL-QOL) Questionnaireemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  This prospective, cross-sectional study evaluated the impact of dysphagia on quality of life in healthy ageing and in subjects with Parkinson’s disease (PD) using the Swallowing Quality of Life (SWAL-QOL) questionnaire. Sixteen healthy young adults (8 males, mean age = 25.1 years) and 16 healthy elders (8 males, mean age = 72.8 years) were recruited. Thirty-two subjects with idiopathic PD (mean age = 68.5 years) were recruited from a movement disorders clinic. The severity of PD was staged using the Hoehn and Yahr scale. Results revealed that elders exp...
Source: Dysphagia - August 18, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Sensory and Motor Responses of Normal Young Adults During Swallowing of Foods with Different Properties and Volumesemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We examined the influence of rheological/textural properties and volumes of test foods on the sensory and motor aspects of swallowing in healthy young adults. Three test foods differing in thickening agent concentration (0.0, 1.5, and 3.0%) were prepared and delivered in different volumes (~3, ~5, and ~7 ml) to subjects seated on a chair. Viscosity analyses of the 1.5 and 3.0% test foods revealed that they behaved as non-Newtonian fluids and were thixotropic. The 1.5% test food differed from the 3.0% test food in its textural properties (hardness, cohesiveness, and adhesiveness). As determined by a linea...
Source: Dysphagia - August 18, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

High-Resolution Esophageal Manometry with ECG Monitoring for Management of Premature Ventricular Complexes-Associated Dysphagiaemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We report a novel technique for diagnosing a new cause of esophageal dysphagia in a patient without organic heart and esophageal disease. A coincidence between intermittent esophageal dysphagia and cardiac arrhythmia, frequent premature ventricular complexes (PVC) were confirmed by clinical observation, simultaneous ECG monitoring, and motility study. High-resolution esophageal manometry (HRM) revealed abnormal peristaltic waves only during frequent PVC. Abnormal peristaltic waves and PVC disappeared simultaneously and completely within 15 min after intravenous infusion of antiarrhythmic agent (140 mg propafe...
Source: Dysphagia - August 12, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Confirmation of No Causal Relationship Between Tracheotomy and Aspiration Status: A Direct Replication Studyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Debate continues regarding an association between tracheotomy and aspiration status. The aim of this research was to perform a direct replication study to investigate further the causal relationship, if any, between tracheotomy and aspiration. Twenty-five consecutive adult hospitalized patients participated. Inclusion criteria were a pretracheotomy dysphagia evaluation, subsequent tracheotomy and tracheotomy tube placement, then a post-tracheotomy dysphagia reevaluation prior to decannulation. Twenty-two (88%) participants exhibited the same aspiration status or resolved aspiration pre- versus post-...
Source: Dysphagia - August 12, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Perceptions of Psychological Issues Related to Dysphagia Differ in Acute and Chronic Patientsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
The objectives of this study were (1) to compare and contrast the psychological issues perceived by patients with oropharyngeal dysphagia and explore if the differences relate to recovery trajectory, and (2) to determine whether patients, caregivers, and clinicians had different perceptions of how psychological issues interacted with the lung and nutrition issues as consequences of dysphagia. Two focus groups (one each of acute and chronic patients) were conducted with a total of 8 participants. Four focus groups (3 with clinicians and 1 with caregivers) were also conducted. Through the constant comparison method of gr...
Source: Dysphagia - August 6, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Maximal Hyoid Excursion in Poststroke Patientsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Reduced maximal hyoid excursion has been suspected as one of the primary physiologic causes of aspiration after a stroke. Vertical and anterior displacement of hyoid excursion is critical to epiglottic closure for airway protection and the opening of the upper esophageal sphincter (UES). Without these carefully timed and well-executed components, the bolus cannot pass safely through the pharynx. The purpose of this study was to evaluate vertical and anterior displacement of the hyoid bone during oropharyngeal swallowing in two groups of subjects: (1) 16 stroke patients who aspirate before or during ...
Source: Dysphagia - August 4, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Clinical Significance of Oral Intake in Patients with Acute Strokeemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  We investigated the feeding method and predictors for oral intake difficulty for a month after acute stroke. In 107 consecutive patients, swallowing function was assessed using a bedside screening protocol within 48 h of admission. The method of feeding was followed for 4 weeks, and predictors for “non-oral intake” on admission and 4 weeks later were analyzed. Sixty-two patients (58%) were fed any type of food orally within 48 h of admission, and 91 patients (84%) were fed orally 4 weeks later. Independent predictors for non-oral intake within 48 h of admission were...
Source: Dysphagia - August 4, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Simple Swallowing Provocation Test Has Limited Applicability as a Screening Tool for Detecting Aspiration, Silent Aspiration, or Penetrationemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  A number of tests for evaluating dysphagia without using videofluoroscopic examination of swallowing (VF) or videoendoscopic evaluation of swallowing (VE) have been developed. The simple swallowing provocation test (SSPT) is unique because it is performed while in a supine position and does not require the patient’s cooperation. However, whether the SSPT detects aspiration or penetration correctly is unclear because its validity determined by VF or VE has not been evaluated. Therefore, we determined the sensitivity, specificity, and predictive accuracy of SSPT followed by VF in 45 patients. The se...
Source: Dysphagia - July 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Ultrasound Imaging of Infant Swallowing During Breast-Feedingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Coordination of infants’ suck-swallow-breathing patterns is integral to safe and efficient feeding. However, assessment of these patterns is difficult and often invasive, particularly in breast-fed infants less than 4 months of age. The aims of this study were to develop an ultrasound approach to visualize swallowing in term breast-feeding infants and to determine the accuracy of ultrasound imaging of swallowing compared to respiratory inductive plethysmography (RIP). On ultrasound, the breast milk bolus was observed as a predominantly echogenic area moving inferiorly. Of the 388 swallows det...
Source: Dysphagia - July 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Outcomes of Dysphagia Intervention in a Pulmonary Rehabilitation Programemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  People with chronic obstructive pulmonary disease (COPD) or chronic respiratory disease demonstrate an increased prevalence of oropharyngeal dysphagia as a consequence of impaired coordination between respiration and swallowing function. To date, the effect of patient education and intervention on the management of oropharyngeal dysphagia within pulmonary rehabilitation programs has not been reported or evaluated. Data were collected on participants who were enrolled in the Outpatient Pulmonary Rehabilitation Program and who received dysphagia intervention. Intervention consisted of some or all of t...
Source: Dysphagia - July 22, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Tongue Pressure Patterns During Water Swallowingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This study examined how pressures generated by the tongue against the hard palate differed between three points along the midline of the tongue. Specifically, we tested three hypotheses: (1) that there are defined individual patterns of pressure change within the mouth during liquid swallowing; (2) that there are significant negative pressures generated at defined moments during normal swallowing; and, (3) that liquid swallowing is governed by the interplay of pressures generated in an anteroposterior direction in the mouth. Using a metal appliance described previously, we measured absolute pressures during water swal...
Source: Dysphagia - July 1, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

A Novel Stable Isotope Approach for Determining the Impact of Thickening Agents on Water Absorptionemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Research on the bioavailability of water from thickened fluids has recently been published and it concluded that the addition of certain thickening agents (namely, modified maize starch, guar gum, and xanthan gum) does not significantly alter the absorption of water from the healthy, mature human gut. Using xanthan gum as an example, our “proof of concept” study describes a simple, accurate, and noninvasive alternative to the methodology used in that first study, and involves the measurement and comparison of the dilution space ratios of the isotopes 2H and 18O and subsequent calculation of tota...
Source: Dysphagia - June 26, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Comments on Selected Recent Dysphagia Literatureemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory CommentsDOI 10.1007/s00455-009-9240-1Authors Clarence T. Sasaki, Yale University School of Medicine Department of Surgery, Section of Otolaryngology P.O. Box 208041 New Haven CT 06520-8041 USASteven B. Leder, Yale University School of Medicine Department of Surgery, Section of Otolaryngology P.O. Box 208041 New Haven CT 06520-8041 USA Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)
Source: Dysphagia - June 16, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Myosin Heavy-Chain Composition of the Human Hyoglossus Muscleemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The human tongue muscle hyoglossus (HG) is active in oromotor behaviors encompassing a wide range of tongue movement speeds. Here we test the hypothesis that the human HG is composed of “uncommon” myosin heavy-chain (MHC) isoforms MHCembryonic, MHCneonatal, and MHCslow tonic as has been reported for other head and neck muscles active during kinematically diverse behaviors. Following reaction of human HG with antibodies specific for MHCI, MHCIIA, MHCII, MHCembryonic, MHCextraocular, MHCneonatal, and MHCslow tonic, only antibodies to MHCI, MHCIIA, and MHCII label more than occasional muscle fibers...
Source: Dysphagia - June 13, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Comments on Selected Recent Dysphagia Literatureemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory CommentsDOI 10.1007/s00455-009-9228-xAuthors Clarence T. Sasaki, Yale University School of Medicine Department of Surgery, Section of Otolaryngology P.O. Box 208041 New Haven CT 06520-8041 USASteven B. Leder, Yale University School of Medicine Department of Surgery, Section of Otolaryngology P.O. Box 208041 New Haven CT 06520-8041 USA Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)
Source: Dysphagia - June 5, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

A Mouse Model of Pharyngeal Dysphagia in Amyotrophic Lateral Sclerosisemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  We recently established that the SOD1-G93A transgenic mouse is a suitable model for oral-stage dysphagia in amyotrophic lateral sclerosis (ALS). The purpose of the present study was to determine whether it could serve as a model for pharyngeal-stage dysphagia as well. Electrophysiological and histological experiments were conducted on end-stage SOD1-G93A transgenic mice (n = 9) and age-matched wild-type (WT) littermates (n = 12). Transgenic mice required a twofold higher stimulus frequency (40 Hz) applied to the superior laryngeal nerve (SLN) to evoke swallowing compared wit...
Source: Dysphagia - June 4, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Anthropometric and Demographic Correlates of Dual-Axis Swallowing Accelerometry Signal Characteristics: A Canonical Correlation Analysisemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Swallowing accelerometry has been proposed as a potential minimally invasive tool for collecting assessment information about swallowing. The first step toward using sounds and signals for dysphagia detection involves characterizing the healthy swallow. The purpose of this article is to explore systematic variations in swallowing accelerometry signals that can be attributed to demographic factors (such as participant gender and age) and anthropometric factors (such as weight and height). Data from 50 healthy participants (25 women and 25 men), ranging in age from 18 to 80 years and with approxi...
Source: Dysphagia - June 4, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Accuracy of Clinical Judgment of the Chin-Down Posture for Dysphagia During the Clinical/Bedside Assessment as Corroborated by Videofluoroscopy in Adults with Acute Strokeemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Speech-language pathologists tend to rely on the noninstrumental swallowing evaluation in making recommendations about a patient’s diet and management plan. The present study was designed to examine the sensitivity and specificity of the accuracy of using the chin-down posture during the clinical/bedside swallowing assessment. In 15 patients with acute stroke and clinically suspected oropharyngeal dysphagia, the correlation between clinical and videofluoroscopic findings was examined. Results identified that there is a difference in outcome prediction using the chin-down posture during the clinica...
Source: Dysphagia - May 30, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

A Randomized Study Comparing the Shaker Exercise with Traditional Therapy: A Preliminary Studyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  Seven institutions participated in this small clinical trial that included 19 patients who exhibited oropharyngeal dysphagia on videofluorography (VFG) involving the upper esophageal sphincter (UES) and who had a 3-month history of aspiration. All patients were randomized to either traditional swallowing therapy or the Shaker exercise for 6 weeks. Each patient received a modified barium swallow pre- and post-therapy, including two swallows each of 3 ml and 5 ml liquid barium and 3 ml barium pudding. Each videofluorographic study was sent to a central laboratory and digitized in o...
Source: Dysphagia - May 27, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Cricopharyngeal Intramural Hematoma: An Unusual Complication of Orthopedic Interventionemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00455-009-9218-zAuthors Marty M. Meyer, The Ohio State University Medical Center Division of Gastroenterology, Hepatology, and Nutrition 395 West 12th Avenue, Suite 200 Columbus OH 43210 USAEdward J. Levine, The Ohio State University Medical Center Division of Gastroenterology, Hepatology, and Nutrition 395 West 12th Avenue, Suite 200 Columbus OH 43210 USA Journal DysphagiaOnline ISSN 1432-0460Print ISSN 0179-051X (Source: Dysphagia)
Source: Dysphagia - May 27, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Viscosity in Infant Dysphagia Management: Comparison of Viscosity of Thickened Liquids Used in Assessment and Thickened Liquids Used in Treatmentemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The purpose of this study was to investigate comparability of viscosity of liquids used in assessment and treatment of infants with dysphagia. Goals of this study were as follows: (1) Establish baseline viscosity values for (a) the commercial barium assessment liquids of varying thicknesses and (b) clinically typical infant formula thickened with varied thickeners. (2) Compare the baseline viscosities of the various liquids for correlation of values. We attempted to mimic real-world situations and recreate clinical assessment and treatment conditions. We also identified and made every effort to cont...
Source: Dysphagia - May 27, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Validation of ICD-9 Code 787.2 for Identification of Individuals with Dysphagia from Administrative Databasesemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The aim of this study was to determine the accuracy of dysphagia coding using the International Classification of Diseases version 9 (ICD-9) code 787.2. We used the administrative database of a tertiary hospital and sequential videofluorographic swallowing study (VFSS) reports for patients admitted to the same hospital from January to June 2007. The VFSS reports were abstracted and the hospital’s database was queried to abstract the coding associated with the admission during which the VFSS was performed. The VFSS and administrative data were merged for data analysis. Dysphagia was coded (using co...
Source: Dysphagia - April 28, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Brain Stem Control of the Phases of Swallowingemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  The phases of swallowing are controlled by central pattern-generating circuitry of the brain stem and peripheral reflexes. The oral, pharyngeal, and esophageal phases of swallowing are independent of each other. Although central pattern generators of the brain stem control the timing of these phases, the peripheral manifestation of these phases depends on sensory feedback through reflexes of the pharynx and esophagus. The dependence of the esophageal phase of swallowing on peripheral feedback explains its absence during failed swallows. Reflexes that initiate the pharyngeal phase of swallowing also ...
Source: Dysphagia - April 28, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Maximal Tongue Strength in Typically Developing Children and Adolescentsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This study suggests maximum pediatric tongue strength may be reliably evaluated using commercially available equipment and provides a limited sample comparative database. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00455-009-9215-2Authors Nancy L. Potter, Washington State University Spokane Department of Speech and Hearing Sciences 310 North Riverpoint Blvd P. O. Box 1495 Spokane WA 99210 USARobert Short, Washington State University Spokane Washington Institute for Mental Health Research & Training 310 North Riverpoint Blvd Spokane WA 99210 USA Journal DysphagiaOnline ISSN 1432-0460Print ...
Source: Dysphagia - April 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals

Patient Dose During Videofluoroscopy Swallowing Studies in a Hong Kong Public Hospitalemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Abstract  A videofluoroscopy swallowing study (VFSS) is a major tool in diagnosing swallowing disorders. Like all other medical examinations that involve irradiation, patient dosage is a major concern. Cerebrovascular accident (CVA) and nasopharyngeal carcinoma (NPC) have been two of the most common indicating pathologies for VFSS studies. The goals of this study were to determine the mean dose area product (DAP) value and fluoroscopic time for VFSS examinations in Tuen Mun Hospital, to compare the result with the dose reference level of other similar studies, and to document the results with respect to the v...
Source: Dysphagia - April 24, 2009 Category: Speech Therapy Tags: Dysphagia Source Type: journals