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Oropharyngeal findings of endoscopic examination in swallowing disorders of neurological origin

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Abstract

A study was carried out to examine the significance of anatomical and functional oropharyngeal findings in patients with neurological disorders as part of an endoscopic evaluation of swallowing. The study included 101 patients (60.2 years ± 16.35, 63 male = 62%, 38 female = 38%) with neurological disorders (cerebral infarct, head injury, hypoxia) presenting with dysphagia. Oropharyngeal findings from endoscopic examination of nine anatomical regions and ten functional tests were correlated with the results of a standardised endoscopic swallowing test. Anatomical changes were obtained in 30 (30%) patients; functional changes were obtained in 67 (66%) patients. No correlation between these changes and swallowing ability was found. “Start of swallow,” “leaking,” “residues” and “follow-up swallowing” did show a correlation with the results of the swallowing test. In addition, for swallowing tests with saliva, “follow-up swallowing” and “swallowing after coughing” also showed a correlation. Anatomical or functional endoscopic oropharyngeal examination changes alone did not influence swallowing ability in the mixed neurological group studied. Evaluation of swallowing ability requires a swallowing test with saliva and various test consistencies under normal conditions. Failure to swallow following coughing during swallowing tests with saliva can be used as a clinical indicator for aspiration.

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References

  1. Hiss SG, Postma GN (2003) Fiberoptic endoscopic evaluation of swallowing. Laryngoscope 113:1386–1193

    Article  PubMed  Google Scholar 

  2. Langmore SE (2001) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York

    Google Scholar 

  3. Murray J (1999) The laryngoscopic evaluation of swallowing or FEES. In: Murray J (ed) Manual of dysphagia assessment in adults. Singular Publishing Group, San Diego

    Google Scholar 

  4. Rosenbek JC, Robbins J, Roecker EV (1996) A penetration aspiration scale. Dysphagia 11:93–98

    Article  CAS  PubMed  Google Scholar 

  5. Seidl RO, Nusser-Müller-Busch R, Ernst A (2002) Evaluation eines Untersuchungsbogens zur endoskopischen Schluckuntersuchung. Sprache-Stimme-Gehör 26:28–36

    Article  Google Scholar 

  6. Schneider HJ, Gross M (1997) Dysarthric movement disorders of the velopharynx. HNO 45:460–465

    Article  CAS  PubMed  Google Scholar 

  7. Adachi T, Kogo M, Iida S (1997) Measurement of velopharyngeal movements induced by isolated stimulation of levator veli palatini and pharyngeal constrictor muscles. J Dent Res 76:1745–1750

    Article  CAS  PubMed  Google Scholar 

  8. Feinberg MJ (1993) Radiographic techniques and interpretation of abnormal swallowing in adult and elderly patients. Dysphagia 8:356–358

    Article  CAS  PubMed  Google Scholar 

  9. McConnel FM (1991) Reconstruction of the oral cavity. Dysphagia 6:124–131

    Google Scholar 

  10. Robbins J, Levine R, Wood J (1995) Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol A Biol Sci Med Sci 50:M257–M262

    CAS  PubMed  Google Scholar 

  11. Bastian RW (1991) The videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallow. Otol HNS 104:339–350

    CAS  Google Scholar 

  12. Burns HP, Dayal VS, Scott A (1979) Laryngotracheal trauma: observations on its pathogenesis and its prevention following prolonged orotracheal intubation in the adult. Laryngoscope 89:1316–1325

    CAS  PubMed  Google Scholar 

  13. Leder SB, Ross DA (2005) Incidence of vocal fold immobility in patients with dysphagia. Dysphagia 20:163–167; discussion 168–169

    Article  PubMed  Google Scholar 

  14. Bhattacharyya N, Kotz T, Shapiro J (2002) Dysphagia and aspiration with unilateral vocal cord immobility: incidence, characterization, and response to surgical treatment. Ann Otol Rhinol Laryngol 111:672–679

    PubMed  Google Scholar 

  15. Hiiemae KM, Palmer JB (1999) Food transport and bolus formation during complete feeding sequences on foods of different initial consistency. Dysphagia 14:31–42

    Article  CAS  PubMed  Google Scholar 

  16. Perlman AL, Grayhack JP, Booth BM (1992) The relationship of vallecular residue to oral involvement, reduced hyoid elevation, and epiglottic function. J Speech Hear Res 35:734–741

    CAS  PubMed  Google Scholar 

  17. Medda BK, Kern M, Ren J (2003) Relative contribution of various airway protective mechanisms to prevention of aspiration during swallowing. Am J Physiol Gastrointest Liver Physiol 284:G933–G939

    CAS  PubMed  Google Scholar 

  18. Eisenhuber E, Schima W, Schober E (2002) Videofluoroscopic assessment of patients with dysphagia: pharyngeal retention is a predictive factor for aspiration. AJR Am J Roentgenol 178:393–398

    PubMed  Google Scholar 

  19. Linden P, Kuhlemeier KV, Patterson C (1993) The probability of correctly predicting subglottic penetration from clinical observations. Dysphagia 8:170–179

    Article  CAS  PubMed  Google Scholar 

  20. Setzen M, Cohen MA, Perlman PW (2003) The association between laryngopharyngeal sensory deficits, pharyngeal motor function, and the prevalence of aspiration with thin liquids. Otolaryngol Head Neck Surg 128:99–102

    Article  PubMed  Google Scholar 

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Correspondence to Rainer O. Seidl.

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Seidl, R.O., Nusser-Müller-Busch, R., Westhofen, M. et al. Oropharyngeal findings of endoscopic examination in swallowing disorders of neurological origin. Eur Arch Otorhinolaryngol 265, 963–970 (2008). https://doi.org/10.1007/s00405-007-0559-7

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  • DOI: https://doi.org/10.1007/s00405-007-0559-7

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