Dysphagia最新文献

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Compressed Sensing-Based Cine-MRI for Location of Dysphagia and Swallowing Function assessment in Patients with Head and Neck Cancer: A Comparative Study. 基于压缩感知的电影mri对头颈癌患者吞咽困难定位和吞咽功能评估的比较研究。
IF 2.2 3区 医学
Dysphagia Pub Date : 2025-01-23 DOI: 10.1007/s00455-024-10794-z
Xiaobin Guo, Tengfei Ke, Yifan Liu, Chengde Liao, Manzhu Li
{"title":"Compressed Sensing-Based Cine-MRI for Location of Dysphagia and Swallowing Function assessment in Patients with Head and Neck Cancer: A Comparative Study.","authors":"Xiaobin Guo, Tengfei Ke, Yifan Liu, Chengde Liao, Manzhu Li","doi":"10.1007/s00455-024-10794-z","DOIUrl":"https://doi.org/10.1007/s00455-024-10794-z","url":null,"abstract":"<p><p>Cine magnetic resonance imaging (Cine-MRI) may evaluate the swallowing function and locations of patients with dysphagia, which requires very fast imaging speed. Compressed sensing is a technique that allows for faster MRI imaging by sampling fewer data points and reconstructing the image via optimization techniques, crucial for capturing the rapid movements involved in swallowing. This study aimed to analyze swallowing function and locations in patients with head and neck cancer and healthy individuals using Cine-MRI based on compressed sensing. This comparative study enrolled 36 patients with dysphagia and 10 healthy controls at the Department of Radiology, Yunnan Cancer Hospital between June 2020 and January 2021. Significant correlations were found between primary tumor location and Cine-MRI parameters, and between swallowing function and Cine-MRI parameters. The areas under the receiver operating characteristic curve for the combined Cine-MRI-related parameters in predicting mild and severe dysphagia were 0.806 (95% CI: 0.662-0.949). Cine-MRI with compressed sensing may identify swallowing function and abnormal stages of the physiologic swallowing process in patients with dysphagia after treatment.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Swallow Examination Following Laryngectomy: An International e-Delphi Consensus Process. 喉切除术后临床吞咽检查:国际e-Delphi共识过程。
IF 2.2 3区 医学
Dysphagia Pub Date : 2025-01-21 DOI: 10.1007/s00455-024-10785-0
Sarah E Wilson, Bena Brown, Clare L Burns
{"title":"Clinical Swallow Examination Following Laryngectomy: An International e-Delphi Consensus Process.","authors":"Sarah E Wilson, Bena Brown, Clare L Burns","doi":"10.1007/s00455-024-10785-0","DOIUrl":"https://doi.org/10.1007/s00455-024-10785-0","url":null,"abstract":"<p><p>Clinical swallow examination (CSE) following laryngectomy (± pharyngeal resection) remains a critical step in dysphagia evaluation. Whilst the core components of a standard CSE service a broad spectrum of patient populations, no evidence exists examining the essential assessment items specific to CSE in the laryngectomy population. The aim of this study was to identify the tasks, measures and observations considered necessary to include in a CSE post laryngectomy. Using an e-Delphi approach, a 4-round online survey series was undertaken with 34 speech pathologists experienced in laryngectomy swallowing management from 6 countries. In the first round (item generation) participants were provided with the questions from the swallowing outcomes after laryngectomy (SOAL) as stimulus, to generate a list of tasks, measures and observations as well as clarifying questions they would ask the patient during a CSE. In the subsequent e-Delphi rounds the participants rated the importance of the compiled assessment items. A total of 34 items were rated of critical importance for inclusion in a laryngectomy CSE by ≥ 75% of participants. Two thirds of the consensus items (23 items) were patient history and interview questions incorporating medical and swallowing history (4 items) and patient interview (19 items). The remaining 11 items related to swallow tasks and observations (9 items) and onward referral (2 items). These 34 consensus items can be considered as a draft framework for laryngectomy CSE to guide clinical practice and research.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A New Instrument to Define Parental Fear Regarding Feeding Their Children: A Reliability and Validity Study. 一种定义父母对喂养孩子恐惧的新工具:信度和效度研究。
IF 2.2 3区 医学
Dysphagia Pub Date : 2025-01-18 DOI: 10.1007/s00455-024-10800-4
Rabia Yeşilkuş, Selen Serel Arslan
{"title":"A New Instrument to Define Parental Fear Regarding Feeding Their Children: A Reliability and Validity Study.","authors":"Rabia Yeşilkuş, Selen Serel Arslan","doi":"10.1007/s00455-024-10800-4","DOIUrl":"https://doi.org/10.1007/s00455-024-10800-4","url":null,"abstract":"<p><p>This study aimed to develop the 'Fear of Feeding My Child- A Parental Report (FF-PR)', which measures the parental fear of feeding their children, and to determine its reliability and validity. The study consists of the developmental phase and reported the content validity, internal consistency, test-retest reliability, construct, criterion, and discriminant validity. The study included two groups; 'Group I (N = 90)' who had a neurological disorder and their parents, and 'Group II (N = 60)' who were typically developing children without any feeding and swallowing problems and their parents. Limited literature review, clinical experience, and parental interviews have been used in creating the item pool. A panel of 7 experts assessed the content validity in two Delphi rounds. Cronbach's α measured the internal consistency of each item. The test-retest reliability was determined using the FF-PR scores given by the parents in Group I one week apart. Confirmatory factor analysis was used to measure the construct validity. The Nordic Orofacial Screening Test (NOT-S), Dysphagia Disorder Survey (DDS), and the Turkish version of the Feeding-Swallowing Impact Survey (T-FS-IS) were used for the criterion validity of the FF-PR. The discriminant validity of the FF-PR was determined by comparing the FF-PR scores of the groups and using the receiver-operating characteristic (ROC) curve. The content validity index was 0.92. The Cronbach's α was found to be high (test: 0.966, retest: 0.969). The FF-PR had an excellent chi-square fit (χ<sup>2</sup>/df = 123.075/127 p = 0.582) and according to the fit indices; the FF-PR was found to have a good fit. There was a low-moderate correlation between FF-PR and NOT-S (r = 0.335 - 0.462, p < 0.001) and DDS (r = 0.461 - 0.535, p < 0.001) and a moderate-high correlation between FF-PR and T-FS-IS (r = 0.501 - 0.807, p < 0.001). The FF-PR total and subscale scores were higher in Group I than in Group II. In conclusion, the FF-PR scale is a valid and reliable tool for measuring parental fear about feeding their child.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Compensatory Swallowing Strategies Recommended in Oncology Practice: Practice Patterns and Relationship to Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) Grades. 肿瘤学实践中推荐的补偿性吞咽策略:实践模式及其与吞咽毒性动态影像分级(DIGEST)分级的关系。
IF 2.2 3区 医学
Dysphagia Pub Date : 2025-01-18 DOI: 10.1007/s00455-024-10799-8
Barbara M Ebersole, Julianna Chapman, Carla L Warneke, Sheila Buoy, X Tang, Holly McMillan, Ella Aldridge, Carly E A Barbon, Katherine A Hutcheson
{"title":"Compensatory Swallowing Strategies Recommended in Oncology Practice: Practice Patterns and Relationship to Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) Grades.","authors":"Barbara M Ebersole, Julianna Chapman, Carla L Warneke, Sheila Buoy, X Tang, Holly McMillan, Ella Aldridge, Carly E A Barbon, Katherine A Hutcheson","doi":"10.1007/s00455-024-10799-8","DOIUrl":"https://doi.org/10.1007/s00455-024-10799-8","url":null,"abstract":"<p><p>Compensatory swallow strategies are recommended to improve swallow safety and efficiency; however, there is limited evidence on use in specific populations or their relationship to swallow study results. We sought to describe/explore strategy recommendations in an oncology practice and their relationship to Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) grades as a marker of clinical utility of the tool. This is a sub-study of a STARI-guided retrospective implementation evaluation at a single comprehensive cancer center. Electronic health record databases were queried to sample all modified barium swallow studies (MBS) for all adult oncology patients from 2016 to 2021, excluding total laryngectomy, leak studies and those with missing DIGEST grades. For patients with multiple MBS studies across the study period, one MBS was randomly selected to be included in the analytic sample. DIGEST grade, diet recommendation, oncologic details, and swallow strategy details were chart abstracted. Strategies and oral intake recommendations were classified from least to most restrictive. This study included 4570 patients representing diverse oncology populations (46% head and neck). DIGEST grades indicating at least mild dysphagia (grades ≥ 1) were reported in 2486 of MBS (54%). Strategies were recommended in 2028 MBS (44%). As DIGEST grade increased so did strategy utilization and complexity (Spearman's r (r<sub>S</sub>) = 0.76, p < 0.0001). This pattern was consistent for Safety (r<sub>S</sub> = 0.68) and Efficiency (r<sub>S</sub> = 0.73) grades (both p < 0.0001). Swallow strategies are frequently recommended in oncology populations. This is the first study to show a systematic link between DIGEST grade and MBS compensatory strategy recommendations, supporting clinical effectiveness of DIGEST as an evidence-based practice tool.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cine-MRI of Deglutition: A Systematic Review. 吞咽的电影磁共振成像:一个系统的回顾。
IF 2.2 3区 医学
Dysphagia Pub Date : 2024-12-27 DOI: 10.1007/s00455-024-10797-w
Marin Chauvel, Christophe Tessier, Aïna Venkatasamy, Sandrine Estebe, Franck Jégoux
{"title":"Cine-MRI of Deglutition: A Systematic Review.","authors":"Marin Chauvel, Christophe Tessier, Aïna Venkatasamy, Sandrine Estebe, Franck Jégoux","doi":"10.1007/s00455-024-10797-w","DOIUrl":"https://doi.org/10.1007/s00455-024-10797-w","url":null,"abstract":"<p><p>Videofluoroscopy, recognized as the gold standard for dysphagia exploration, has inherent limitations, including poor soft tissue discrimination, radiation exposure, and aspiration risk. In response to these challenges, cine-MRI of swallowing has evolved over the past three decades, yielding diverse methodologies and results across various studies.This systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, meticulously outlines cine-MRI protocols, applications, advantages, and limitations. Our qualitative analysis encompasses 36 studies involving 715 subjects from 2001 to 2023. Cine-MRI, a promising alternative, provides safe application for dysphagic patients, offering insights into the intricacies of deglutition mechanisms and eliminating the necessity for oral contrast material. Notably, this approach is adaptable to both 1.5 and 3T MRI scanners with specific image acceleration protocols.Despite these merits, a crucial gap remains, as no non-inferiority prospective study has yet been conducted to compare cine-MRI with the gold standard. Additionally, the lack of uniform swallowing assessment criteria and the uncertain impact of the supine position underscore the need for further investigation. In conclusion, while cine-MRI of deglutition emerges as a compelling tool for dysphagia exploration, its precise indications and role in the diagnostic approach to swallowing disorders necessitate comprehensive evaluation in future studies.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Influence of Strength and Skill Parameters on the Evolution of Dysphagia Post Stroke: A Prospective Study. 力量和技能参数对脑卒中后吞咽困难演变的影响:一项前瞻性研究。
IF 2.2 3区 医学
Dysphagia Pub Date : 2024-12-21 DOI: 10.1007/s00455-024-10796-x
Marion Girod-Roux, Esther Guiu Hernandez, Karen B Ng, Phoebe R Macrae, Maggie-Lee Huckabee
{"title":"The Influence of Strength and Skill Parameters on the Evolution of Dysphagia Post Stroke: A Prospective Study.","authors":"Marion Girod-Roux, Esther Guiu Hernandez, Karen B Ng, Phoebe R Macrae, Maggie-Lee Huckabee","doi":"10.1007/s00455-024-10796-x","DOIUrl":"https://doi.org/10.1007/s00455-024-10796-x","url":null,"abstract":"<p><p>The role of pathophysiological deficits in the evolution of dysphagia post-stroke is unclear. This observational, longitudinal study aimed to document the evolution and relationship between strength and precision of submental contraction, and swallowing outcomes at six months. Participants were recruited from a tertiary acute hospital after a first acute stroke. Sociodemographic data and stroke typology were documented. Outcome measures were collected five times across six months. These included: oral diet (FOIS, IDDSI), functional ingestion (TOMASS, TWST), self-reported swallowing-related quality of life (SWAL-QOL), and submental muscle strength and precision contraction as assessed using surface electromyography coupled with biofeedback during saliva swallowing and jaw-opening tasks. Mixed effects models and multiple regressions analyses were conducted. Participants (N = 22, mean age 73.9 ± 14.4 years, 9 males) were recruited at a mean time of 2.8 ± 1.5 days after stroke. Strength parameters (effortful swallow hit rate) improved between ten days and one month post-stroke (p = 0.04). Swallowing temporal precision improved significantly between one and six months (p < 0.01). At six months, participants with decreased swallowing precision also had decreased quality of life (p = 0.04) and increased ingestion time of fluids (p = 0.002). This study is a novel step in exploring the nature and evolution of strength and precision parameters of swallowing muscle activation, and their impact on dysphagia recovery. As swallowing precision was associated with poorer functional outcomes, further studies are warranted to improve early differential diagnosis of patients at risk of chronic dysphagia.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Measurement Properties of the Dysphagiameter for the Assessment of Dysphagia in Oculopharyngeal Muscular Dystrophy. 吞咽困难测量仪评定眼咽肌营养不良患者吞咽困难的测量特性。
IF 2.2 3区 医学
Dysphagia Pub Date : 2024-12-21 DOI: 10.1007/s00455-024-10791-2
Claudia Côté, Bernard Brais, Charles Sèbiyo Batcho, Jean-Denis Brisson, Sarah Youssof, Emmanuel Sègnon Sogbossi, Cynthia Gagnon
{"title":"Measurement Properties of the Dysphagiameter for the Assessment of Dysphagia in Oculopharyngeal Muscular Dystrophy.","authors":"Claudia Côté, Bernard Brais, Charles Sèbiyo Batcho, Jean-Denis Brisson, Sarah Youssof, Emmanuel Sègnon Sogbossi, Cynthia Gagnon","doi":"10.1007/s00455-024-10791-2","DOIUrl":"https://doi.org/10.1007/s00455-024-10791-2","url":null,"abstract":"<p><p>Oculopharyngeal muscular dystrophy (OPMD) is a rare late-onset muscle disease with progressive dysphagia as a major symptom. The Dysphagiameter is a newly developed patient-reported outcome measure (PROM) to assess the severity of dysphagia and its impact in patients with OPMD. This article reports on item reduction and a first assessment of the Dysphagiameter's psychometrics properties, in a French and English-speaking population of individuals with OPMD. Classical test theory and Rasch model were used for item reduction and scoring (n = 162). Construct validity was assessed using the time to drink 80 ml of cold water and the Sydney Swallow Questionnaire (SSQ) (n = 40). Part A of the final PROM resulted in a 21-item scale assessing the capacity to swallow foods of various textures and a 3-item scale assessing the capacity to swallow liquids (Cronbach Alpha = 0.90); the hierarchical structure of the 21-item scale was confirmed with a Rasch analysis (Person separation index = 0.95). Part B resulted in a 6 item-scale assessing the impact on mealtime and a 2-item scale assessing discomfort related to thick saliva (Alpha Cronbach = 0.91 and 0.79). Convergent validity was demonstrated by significant correlations with the SSQ. Known-group validity was supported by the ability of the Dysphagiameter to detect significant differences according to the severity of dysphagia. In summary, the Dysphagiameter-OPMD, a newly developed PROM, exhibits strong psychometric properties and holds promise as a valuable tool for assessing the severity of dysphagia and its impact on individuals with OPMD.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identifying Paediatric Populations with Increased Risk for Oropharyngeal Dysphagia in Acute and Critical Care Settings: A Scoping Review. 识别急性和危重护理环境中口咽吞咽困难风险增加的儿科人群:一项范围审查。
IF 2.2 3区 医学
Dysphagia Pub Date : 2024-12-20 DOI: 10.1007/s00455-024-10795-y
Christie Grunke, Jeanne Marshall, Anna Miles, Bronwyn Carrigg, Elizabeth C Ward
{"title":"Identifying Paediatric Populations with Increased Risk for Oropharyngeal Dysphagia in Acute and Critical Care Settings: A Scoping Review.","authors":"Christie Grunke, Jeanne Marshall, Anna Miles, Bronwyn Carrigg, Elizabeth C Ward","doi":"10.1007/s00455-024-10795-y","DOIUrl":"https://doi.org/10.1007/s00455-024-10795-y","url":null,"abstract":"<p><p>Dysphagia is common in hospitalised children. Clarity regarding its prevalence is required to direct service needs. This review reports oropharyngeal dysphagia prevalence in children admitted to acute and/or critical care, following acute illness, medical or surgical intervention. It also explores patient characteristics significantly associated with oropharyngeal dysphagia in these settings. Five electronic databases (EMBASE, CINAHL, Cochrane, PubMed, Scopus) were searched. Studies identified for inclusion involved children (0-16 years), in acute or critical care settings, where prevalence data for new-onset or worsening oropharyngeal dysphagia was reported. Peer reviewed journal articles, including systematic reviews were included. Data was extracted and synthesised using a purpose designed extraction tool. A total of 7,522 studies were screened and 67 studies met criteria. The most researched populations included congenital heart disease surgeries, posterior fossa tumour resections, stroke and post-extubation dysphagia. Populations with the highest documented dysphagia prevalence were children after posterior fossa tumour resection with a new tracheostomy, children using nasal continuous positive airway pressure, and children following ischemic stroke. Characteristics significantly associated with oropharyngeal dysphagia were younger age, lower weight, longer intubation, upper/middle airway dysfunction (e.g., vocal paresis), and presence of additional comorbidities. This review presents synthesised prevalence data for children in acute and critical care settings with new-onset or worsening oropharyngeal dysphagia. It highlights the broad nature of oropharyngeal dysphagia in hospitalised children and the need for more rigorous research into characteristics associated with increased risk to better support screening and early identification of oropharyngeal dysphagia in these settings.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Respiratory-Swallow Coordination may be Related to Aspiration in Infratentorial Stroke Patients. 幕下脑卒中患者的呼吸-吞咽协调可能与误吸有关。
IF 2.2 3区 医学
Dysphagia Pub Date : 2024-12-19 DOI: 10.1007/s00455-024-10793-0
Jia Qiao, Meng Dai, Fang Sun, Zhi-Min Wu, Lian Wang, Qiu-Pin Ye, Yong Dai, Hong-Mei Wen, Zu-Lin Dou
{"title":"The Respiratory-Swallow Coordination may be Related to Aspiration in Infratentorial Stroke Patients.","authors":"Jia Qiao, Meng Dai, Fang Sun, Zhi-Min Wu, Lian Wang, Qiu-Pin Ye, Yong Dai, Hong-Mei Wen, Zu-Lin Dou","doi":"10.1007/s00455-024-10793-0","DOIUrl":"https://doi.org/10.1007/s00455-024-10793-0","url":null,"abstract":"<p><p>To investigate the characteristics of respiratory-swallow coordination (RSC) in poststroke dysphagia (PSD) patients following infratentorial stroke (IS) and further explore their association with aspiration. PSD patients after IS and age-matched healthy controls were recruited. Nasal airflow and sound signals were recorded using a nasal cannula-type flow sensor and contact microphone, which were synchronized with videofluoroscopic swallowing studies (VFSS). For healthy controls, only nasal airflow and sound signals recordings were conducted. A 5 ml thickened liquid was utilized during these assessments. The penetration-aspiration scale (PAS) score was determined through VFSS. Various parameters, including swallowing apnoea duration (SAD), swallowing duration (SD), swallowing latency duration (SLD), number of swallows (NS), and RSC patterns, were analysed to assess RSC. A total of 37 patients with PSD following IS-comprising 25 non-aspirators and 12 aspirators-and 31 age-matched healthy controls were included. The PSD patient group exhibited a shorter SAD (p = 0.016), a longer SD (p = 0.000), and fewer NS (p = 0.000) compared to the healthy control group. Among the PSD patients, those who aspirated exhibited a notably shorter SAD (p = 0.018) and longer SD (p = 0.028) compared to non-aspirators. The prevalence of the swallow-inspiration pattern was higher in PSD patients (p = 0.006), particularly among those who aspirated (p = 0.010). Logistic regression analysis and the area under the receiver operating characteristic curve (AUC) indicated that both SAD (AUC = 0.825, p = 0.002) and SD (AUC = 0.757, p = 0.020) were significant predictors of aspiration. The optimal cut-off values for SAD and SD were determined to be 0.19s and 1.93s, respectively. The RSC characteristics in patients with PSD following IS differed from those observed in healthy controls, particularly among patients who experienced aspiration. In these patients, a shorter SAD and longer SD may contribute to an increased risk of aspiration.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cranial Nerve Deficits Predict Pharyngeal Phase Swallowing Impairment in Patients with Neurogenic Dysphagia: A Cross-Sectional Study. 颅神经损伤可预测神经源性吞咽困难患者的咽相吞咽障碍:一项横断面研究。
IF 2.2 3区 医学
Dysphagia Pub Date : 2024-12-09 DOI: 10.1007/s00455-024-10787-y
Sara Nordio, Lorenza Maistrello, Isabella Koch, Daniela D'Imperio, Irene Battel
{"title":"Cranial Nerve Deficits Predict Pharyngeal Phase Swallowing Impairment in Patients with Neurogenic Dysphagia: A Cross-Sectional Study.","authors":"Sara Nordio, Lorenza Maistrello, Isabella Koch, Daniela D'Imperio, Irene Battel","doi":"10.1007/s00455-024-10787-y","DOIUrl":"https://doi.org/10.1007/s00455-024-10787-y","url":null,"abstract":"<p><p>The examination of the cranial nerves (CN) provides an accurate analysis of facial-oral integrity, motility and sensitivity that is fundamental to understanding swallowing efficiency. The aim of this cross-sectional study is to verify whether the assessment of CN can provide information on the amount and location of pharyngeal residue and risk of aspiration in patients with neurogenic dysphagia. A total of 96 dysphagic patients have been enrolled. Pharyngeal residue was assessed by the Italian version of the Yale Pharyngeal Residue Severity Rating Scale (IT-YPRSRS) and presence of penetration/aspiration using the Penetration-Aspiration Scale (PAS) during Fiberoptic Endoscopic Evaluation of Swallowing (FEES), while CNs were evaluated using the I&I test. Logistic regression models were used to investigate causal associations; for each of the CN found to be significant, the optimal cut-off to best discriminate healthy patients from those with pathology was calculated. All statistical analyses were performed using R software with the significance level set at P < 0.05. Significant correlations were found between total scores on the I&I test and the PAS and IT-YPRSRS results. Impairment of CN VII was a sensitive and specific predictor of vallecular residue. Deficits of V CN and X CN were predictors of pyriform sinus residue. PAS scores were just below the statistical significance. Assessing CN can provide specific pathophysiological information about pharyngeal residue and risk of penetration/aspiration. These findings could help clinicians understand swallowing issues and early plan targeted interventions.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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