Swallowing after right hemisphere stroke: oral versus pharyngeal deficits
Although previous studies have attempted to identify distinct patterns of dysphagia following unilateral hemispheric stroke, the relationships between lesion sites and swallowing dysfunction remain unclear. In particular, swallowing deficits resulting from right hemisphere stroke remain poorly understood. The present study employed a case report design to examine the oral and pharyngeal phase deficits in swallowing following right hemisphere stroke. Lateral-view videofl uoroscopic images were obtained from six subjects following right hemisphere stroke as they performed swallowing trials with various bolus consistencies (i.e., thin liquid, thick liquid, and paste). Each swallow was evaluated on 17 oral phase, and 17 pharyngeal phase physiologic swallowing parameters. Results indicated that, whereas all patients exhibited both oral and pharyngeal phase swallowing defi cits, the majority of patients showed relatively greater oral phase than pharyngeal phase impairment. In addition, patterns of swallowing defi cits were highly variable across individuals, particularly for the pharyngeal phase. These fi ndings suggest that oral phase swallowing impairment can be a prominent feature of right hemisphere stroke. Thus, swallowing assessment in patients with right hemisphere stroke should emphasize both oral and pharyngeal phases. Instrumental techniques can provide valuable insights into swallow pathophysiology in this population.
Posted on November 13, 2008, in Research and tagged barium sulfate, case studies, deglutition disorders, descriptive statistics, fluoroscopy, functional assessment, funding source, pharynx, purposive sample, right hemisphere, stroke, tomography, tongue, x-ray computed. Bookmark the permalink. 1 Comment.