Blog Archives

Fiberoptic Endoscopic Evaluation of Swallowing in children: Feeding outcomes related to diagnostic groups and endoscopic findings

Conclusion
Many children overcome their dysphagia but those with neurologic disorders are less likely to achieve total oral feeding status. In children with dysphagia evaluated by FEES, the long-term feeding status is not significantly associated with the initial FEES findings.

from the International Journal of Pediatric Otorhinolaryngology

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Medicine administration errors in patients with dysphagia in secondary care: a multi-centre observational study

Conclusion.  The increased medicine administration error rate in patients with dysphagia requires healthcare professionals to take extra care when prescribing, dispensing and administering medicines to this group.

from the Journal of Advanced Nursing

Classification of healthy and abnormal swallows based on accelerometry and nasal airflow signals

This exploratory study confirms that dual-axis accelerometry and nasal airflow signals can be used to discriminate healthy and abnormal swallows from patients with dysphagia. The fact that features from all signal channels contributed discriminatory information suggests that multi-sensor fusion is promising in abnormal swallow detection.

from Artificial Intelligence in Medicine

Swallowing disturbance questionnaire for detecting dysphagia†‡

The SDQ is a sensitive and accurate tool for identifying patients with true swallowing disturbances arising from different etiologies and for indicating the need for more in-depth instrumental swallowing evaluations.

from The Laryngoscope

A Rare Cause of Dysphagia: A Case Report

Dysphagia is a common clinical symptom for an ENT surgeon in his clinic, evaluation of which may not be a great challenge. The objective of this article is to report a rare cause of dysphagia which may be difficult to diagnose unless specifically thought of. This is a report of a case of dysphagia secondary to myasthenia gravis seen in a young lady along with tongue fasciculation in an early onset case unlike the ones reported in the literature where the patients are elderly and more often males in the late phase of the disease. At times, dysphagia may be seen secondary to some rare causes and may mislead the doctor. A carefully taken history and methodical clinical examination will avoid unnecessary invasive procedures and delay in the diagnosis.

from the Indian Journal of Otolaryngology

Clinical Challenges in the Evaluation and Treatment of Individuals with Poststroke Dysphagia

Although reported frequencies vary due to study design, patient characteristics, and method of ascertainment, dysphagia is a commonly encountered morbidity after stroke. Consequently, speech-language pathologists’ clinical caseloads are heavily populated with individuals with poststroke dysphagia. The body of knowledge about swallowing and swallowing disorders has expanded exponentially over the last 3 decades, and speech-language pathologists are increasingly sophisticated in their evaluation and treatment of this patient population. Nevertheless, clinical quandaries persist regarding the management of these individuals. In this article, clinical challenges are discussed, including early detection of dysphagia and aspiration risk, treatment efficacy, refractory dysphagia, and noncompliance with treatment. Research relevant to these issues is reviewed to aid in formulating sound clinical decisions.

from Topics in Stroke Rehabilitation

Dysphagia Management: A Survey of School-Based Speech-Language Pathologists in Vermont

Conclusion: This study expanded previous research in this area. Factors accounting for our results, limitations, directions for future research, and implications for practice are discussed.

from Language, Speech and Hearing Services in Schools

Oro-buccal symptoms (dysphagia, dysarthria, and sialorrhea) in patients with Parkinson’s disease: preliminary analysis from the French COPARK cohort

Oro-buccal symptoms were present in two of three patients with moderate PD, the presence of each symptoms being significantly correlated with that of the two others.

from the European Journal of Neurology

Racial Disparities in the Development of Dysphagia After Stroke: Further Evidence From the Medicare Database

Our findings confirm previous research suggesting an association between Asian race and dysphagia after stroke while adding evidence for increased odds in other racial/ethnic minority groups.

from Archives of Physical Medicine and Rehabilitation

Ramsay Hunt Syndrome With Severe Dysphagia

Ramsay Hunt syndrome, first described by J. Ramsay Hunt in 1907, encompassed the symptoms of otalgia, erythematous vesicular rash on the auricle, and facial paralysis. Although rare, in some cases, the varicella zoster virus responsible for the illness can also be associated with involvement of cranial nerves III–XII, cervical nerves, aseptic meningitis, and the syndrome of inappropriate secretion of antidiuretic hormone. We present a case of a patient with clinical evidence of Ramsay Hunt syndrome involving the cranial nerves V, VII, VIII, X, and, possibly, XII. Pharyngeal wall and vocal fold paralysis, and severely reduced laryngeal elevation, resulted in such significant dysphagia that percutaneous endoscopic gastrostomy tube placement was required.

from the Journal of Voice

Comparing the Effects of Rehabilitation Swallowing Therapy vs. Functional Neuromuscular Electrical Stimulation Therapy in an Encephalitis Patient: A Case Study

A 49-year-old man with pharyngeal dysphagia after encephalitis is presented in this case study. Sixteen months earlier the patient experienced a sudden severe fever which resulted in encephalitis, leading to liquid dysphagia. Despite receiving an initial treatment of swallowing therapy, the patient’s liquid dysphagia did not improve. Functional neuromuscular electrical stimulation, which is a new treatment method, was then applied to the patient. The patient showed improvement in the pharyngeal phase of swallowing. Clinical and treatment observations are reported.

from Dysphagia

Assessment of the swallowing function in older individuals referred to myocardial revascularization surgery

CONCLUSION: older individuals with heart disease presented differences in the swallowing function when compared to healthy older individuals. Older individuals with heart disease presented alterations in the temporal coordination between breathing and swallowing, thus indicating risk for dysphagia.

from Pró-Fono Revista de Atualização Científica

Unilateral high vagal paralysis: Relationship of the severity of swallowing disturbance and types of injuries

Conclusions:
High vagal nerve damage from skull base surgery or trauma leads to a higher incidence of feeding tube dependency than that from skull base tumor compression. Patients can be treated successfully with an appropriate injection or medialization thyroplasty. Immediate laryngoplasty is suggested for cases right after skull base surgery or trauma.

from The Laryngoscope

Normal Swallowing Acoustics Across Age, Gender, Bolus Viscosity, and Bolus Volume

Cervical auscultation has been proposed as an augmentative procedure for the subjective clinical swallowing examination due to the tangible differences between normal and dysphagic swallowing sounds. However, the research is incomplete regarding cervical auscultation and swallowing acoustics in that the differences between the sounds of normal versus dysphagic swallowing have yet to be fully understood or quantified. The swallows of 96 reportedly healthy adults, balanced for gender and divided into younger, middle, and older age groups, were audio-recorded while ingesting several boluses of varying viscosity and volume. The audio signals were then analyzed to determine their temporal and acoustic characteristics. Results indicated increasing pharyngeal swallowing duration with increasing age, bolus viscosity, and bolus volume. In addition, an increased duration to peak intensity with increasing age was found in one of our two analyses, as well as with some of the more viscous versus less viscous boluses. Men and older persons produced higher peak intensities and peak frequencies than women and younger persons. Thin liquids were produced with more intensity than honey or more viscous boluses, and with greater frequency than mechanical soft solids. Larger volumes resulted in greater peak frequency values. Some of the acoustic measurements appear to be more useful than others, including the duration of the acoustic swallowing signal and the within-subjects peak intensity variable. We noted that differences in swallowing acoustics were more related to changes in viscosity rather than volume. Finally, within-participant observations were more useful than between-participant observations.

from Dysphagia

Self-Reported Dysphagia and Its Correlates Within a Prevalent Population of People with Parkinson’s Disease

Many people with Parkinson’s disease (PD) experience dysphagia; however, the prevalence of dysphagia in people with PD is unknown. We studied a prevalent population of PD cases. All of those who consented to participate were assessed for anxiety, depression, cognitive function, and quality of life using standard rating scales. Anyone who answered “yes” to either one of the two questions: Do you have difficulty swallowing food/liquid or tablets? and Do you cough after eating/drinking? was considered to have dysphagia. Question 7 of the Unified Parkinson’s Disease Rating Scale (UPDRS) was also used to identify dysphagia. Of 106 prevalent PD cases, 75 (38 males) patients consented to examination and assessment. The prevalence of dysphagia was 32.0% (n = 24; 11 males). Using the response to UPDRS Question 7 as an indicator of the impact of swallowing problems on the patient, there were significant correlations with cognitive function, anxiety, depression, quality of life, and UPDRS-reported gait disturbance, postural instability and problems with falling. There was no correlation with disease duration, age, or gender. Almost one third of the participants reported dysphagia. There was a strong correlation between dysphagia and gross motor skills; patients reporting such problems should be screened for swallowing problems.

from Dysphagia