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Arno Olthoff, Per-Ole Carstens, Shuo Zhang, Eva von Fintel, Tim Friede, Joachim Lotz, Jens Frahm, Jens Schmidt
OBJECTIVE: To assess safety and feasibility of real-time (RT) MRI for evaluation of dysphagia and to compare this technique to standard assessment by flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VF) in a cohort of patients with inclusion body myositis (IBM). METHODS: Using RT-MRI, FEES, and VF, an unselected cohort of 20 patients with IBM was studied as index disease with a uniform dysphagia. Symptoms of IBM and dysphagia were explored by standardized tools including Swallowing-Related Quality of Life Questionnaire (SWAL-QoL), IBM Functional Rating Scale, Patient-Reported Functional Assessment, and Medical Research Council Scale...
October 21, 2016: Neurology
Roxann Diez Gross, Ronit Gisser, Gregory Cherpes, Katie Hartman, Rishi Maheshwary
Prader-Willi Syndrome (PWS) is caused by a genetic imprinting abnormality resulting from the lack of expression of the paternal genes at 15q11-q13. Intellectual disability, low muscle tone, and life-threatening hyperphagia are hallmarks of the phenotype. The need for the Heimlich maneuver, death from choking, and pulmonary infection occur in a disproportionally high number of persons with PWS. The widely held belief is that eating behaviors are responsible for choking and aspiration; yet, no investigation had sought to determine if swallowing impairments were present in persons with PWS...
October 19, 2016: American Journal of Medical Genetics. Part A
A Baumann, P O Katz
Swallowing involves complex coordination of the neuromuscular anatomy and physiology of the oropharynx and esophagus, controlled by the enteric and central nervous systems. Dysphagia is classified as either oropharyngeal or esophageal and results from mechanical or structural disturbances. Videofluoroscopy, fiberoptic endoscopic evaluation of swallowing, barium swallow, manometry, and endoscopy are common modalities utilized in diagnosis, but none is as important as a patient's history. Functional dysphagia is a diagnosis of exclusion and is based on Rome criteria...
2017: Handbook of Clinical Neurology
Telma K Takeshita-Monaretti, Lílian Aguiar-Ricz, Patrícia Bastos, Wilson Marques, Hilton Ricz
OBJECTIVES/HYPOTHESIS: To determine the association of the electrophysiological activity of the pharyngoesophageal transition with tracheoesophageal speech proficiency in total laryngectomees. STUDY DESIGN: An observational (nonexperimental) study of the correlation type with a descriptive approach. METHODS: Thirty-four individuals (26 males), average age 62.5 years, total laryngectomees rehabilitated with the use of a tracheoesophageal prosthesis, were assessed for tracheoesophageal speech proficiency using an adapted protocol and classified as good, moderate, or poor speakers...
September 26, 2016: Laryngoscope
Karin Söderström, Per Nilsson, Göran Laurell, Björn Zackrisson, Eva Levring Jäghagen
PURPOSE: To establish predictive models for late objective aspiration and late patient-reported choking based on dose-volume parameters and baseline patient and treatment characteristics, for patients with head and neck cancer undergoing definitive radiotherapy (RT). The impact of electively treated volume on late aspiration was also investigated. METHODS AND MATERIAL: This prospective cohort is a subsample of 124 survivors from the ARTSCAN study. Late aspiration was identified with videofluoroscopy, at a minimum of 25months after the start of RT...
September 26, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Alba M Azola, Kirstyn L Sunday, Ianessa A Humbert
Submental surface electromyography (ssEMG) visual biofeedback is widely used to train swallowing maneuvers. This study compares the effect of ssEMG and videofluoroscopy (VF) visual biofeedback on hyo-laryngeal accuracy when training a swallowing maneuver. Furthermore, it examines the clinician's ability to provide accurate verbal cues during swallowing maneuver training. Thirty healthy adults performed the volitional laryngeal vestibule closure maneuver (vLVC), which involves swallowing and sustaining closure of the laryngeal vestibule for 2 s...
September 28, 2016: Dysphagia
Naomi Yagi, Shinsuke Nagami, Meng-Kuan Lin, Toru Yabe, Masataka Itoda, Takahisa Imai, Yoshitaka Oku
: The assessment of swallowing function is important for the prevention of aspiration pneumonia. We developed a new swallowing monitoring system that uses respiratory flow, swallowing sound, and laryngeal motion. We applied this device to 11 healthy volunteers and 10 patients with dysphagia. Videofluoroscopy (VF) was conducted simultaneously with swallowing monitoring using our device. We measured laryngeal rising time (LRT), the time required for the larynx to elevate to the highest position, and laryngeal activation duration (LAD), the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the lowest position...
September 24, 2016: Medical & Biological Engineering & Computing
Anna Miles
BACKGROUND: Oesophageal abnormalities are common findings in a speech-language therapy videofluoroscopy clinic. Fluoroscopic screening involving oropharynx alone fails to identify these patients. Oesophageal screening as an adjunct to videofluoroscopy is gaining popularity. Yet currently, little is known about the reliability of speech and language therapists' judgement of the oesophageal phase. AIM: To measure the inter-rater reliability of oesophageal abnormality judgement in speech and language therapists during upright videofluoroscopy...
September 13, 2016: International Journal of Language & Communication Disorders
Pablo Antonio Ysunza, David Bloom, Kongkrit Chaiyasate, Matthew Rontal, Rachel VanHulle, Kenneth Shaheen, Donald Gibson
BACKGROUND: The state of the art for correcting velopharyngeal insufficiency (VPI) is a surgical procedure which is customized according to findings on imaging procedures: multiplanar videofluoroscopy (MPVF) and flexible videonasopharyngoscopy (FVNP). Recently, the use of MPVF has been challenged because of the potential risk of using ionizing radiation, especially in children. OBJECTIVE: To study whether using a protocol for performing MPVF can effectively decrease radiation dose in patients with VPI while providing useful information for planning surgical correction of VPI in combination with FVNP...
October 2016: International Journal of Pediatric Otorhinolaryngology
Thomas Frieling
BACKGROUND: Acute cerebral stroke is a common problem that is frequently associated with dysphagia resulting in an increased risk of aspiration pneumonia, complication, and mortality. METHODS: A literature review was carried out using the search terms 'stroke unit and endoscopy', 'stroke unit and dysphagia', and 'stroke unit and gastroenterology'. RESULTS: Only few papers focus on the role of endoscopy in stroke units. One major role is the early detection of dysphagia by flexible endoscopic evaluation of swallowing (FEES)...
February 2016: Visc Med
Mandy Henderson, Anna Miles, Victoria Holgate, Sophia Peryman, Jacqui Allen
OBJECTIVE: To investigate the feasibility of obtaining and utilizing objective measures of timing and displacement from videofluoroscopy performed in pediatrics. STUDY DESIGN: Children (n = 121; mean age 38 months, range 9 days-21 years, SD 4 years) referred for videofluoroscopy were recruited. All underwent a standardized protocol including a mid-feed 20-second loop recorded at 25 frames per second. Videos were analyzed using objective digital measures of timing and displacement...
August 25, 2016: Journal of Pediatrics
Chelsea C Walczak, Corinne A Jones, Timothy M McCulloch
Determining intrabolus pressure (IBP) at the upper esophageal sphincter (UES) and in the esophagus has given compelling evidence that IBP can be a predictor for swallowing dysfunction. Studies have looked most superiorly at the low hypopharynx region but there has been no inquiry into what IBP measures throughout the entire pharynx can tell us. We present a study to describe the pressures within and surrounding the moving bolus throughout the pharynx and into the UES. Simultaneous high-resolution manometry (HRM) and videofluoroscopy were performed in ten healthy subjects swallowing ten 10 mL thin-liquid barium boluses...
August 26, 2016: Dysphagia
Alison Perry, Siew Hwa Lee, Susan Cotton, Catriona Kennedy
BACKGROUND: Head and neck cancer treatment has developed over the last decade, with improved mortality and survival rates, but the treatments often result in dysphagia (a difficulty in swallowing) as a side effect. This may be acute, resolving after treatment, or remain as a long-term negative sequela of head and neck cancer (HNC) treatment. Interventions to counteract the problems associated with dysphagia include swallowing exercises or modification of diet (bolus texture, size), or both...
2016: Cochrane Database of Systematic Reviews
Martina Scharitzer, Johannes Lenglinger, Wolfgang Schima, Michael Weber, Claudia Ringhofer, Peter Pokieser
OBJECTIVES: To compare videofluoroscopy that included a tablet test with impedance planimetry (EndoFLIP(®)) for the evaluation of oesophageal stenosis in patients with dysphagia. METHODS: In 56 patients, videofluoroscopic examinations following the transit of a 14-mm tablet were retrospectively reviewed and correlated with impedance planimetry findings, a catheter-based method using impedance planimetry to display the oesophageal diameter estimates. Additional findings assessed were the occurrence of symptoms during tablet passage and evaluation of oesophageal motility...
August 23, 2016: European Radiology
Loni C Arrese, Ricardo Carrau, Emily K Plowman
The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC...
August 18, 2016: Dysphagia
Omar Ortega, Laia Rofes, Alberto Martin, Viridiana Arreola, Irene López, Pere Clavé
Oropharyngeal dysphagia (OD) is a prevalent geriatric syndrome. Treatment is based on compensatory strategies to avoid complications. New treatments based on sensory stimulation to promote the recovery of the swallowing function have proved effective in acute studies but prolonged treatment needs further research. Our aim was to evaluate and compare the effect of two, longer-term sensory treatment strategies on older patients with OD. 38 older patients (≥70 years) were studied with videofluoroscopy (pre/posttreatment) and randomized into two 10-day treatment groups: Group A-transient receptor potential vanilloid 1 (TRPV1) agonist (capsaicin 1 × 10(-5) M) and Group B-transcutaneous sensory electrical stimulation (TSES) (Intelect VitalStim, biphasic pulses, 300 μs, 80 Hz)...
October 2016: Dysphagia
Silvia Carrión, Maria Roca, Alicia Costa, Viridiana Arreola, Omar Ortega, Elisabet Palomera, Mateu Serra-Prat, Mateu Cabré, Pere Clavé
BACKGROUND: Oropharyngeal dysphagia (OD) is a prevalent risk factor for malnutrition (MN) in older patients and both conditions are related to poor outcome. OBJECTIVE: To explore the nutritional status in older patients with OD in a chronic and an acute clinical situation. DESIGN: We examined 95 older (≥70 years) patients with OD associated to chronic neurological diseases or aging, and 23 older patients with OD and acute community-acquired pneumonia (CAP) with videofluoroscopy; and 15 older people without OD...
July 26, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Ariel L Camp, Henry C Astley, Angela M Horner, Thomas J Roberts, Elizabeth L Brainerd
Accurate measurements of muscle length changes are essential for understanding the biomechanics of musculoskeletal systems, and can provide insights into muscular work, force, and power. Muscle length has typically been measured in vivo using sonomicrometry, a method that measures distances by sending and receiving sound pulses between piezoelectric crystals. Here, we evaluate an alternative method, fluoromicrometry, which measures muscle length changes over time by tracking the three-dimensional positions of implanted, radio-opaque markers via biplanar videofluoroscopy...
August 2016: Journal of Experimental Zoology. Part A, Ecological Genetics and Physiology
Carla Manfredi Santos, Rachel Aguiar Cassiani, Roberto Oliveira Dantas
BACKGROUND: There are some studies in the literature about the feeding behavior and masticatory process in patients with feeding disorders; however, it is not very well known if there are alterations in oral-pharyngeal swallowing dynamics in subjects with anorexia nervosa. OBJECTIVE: To evaluate the oral and pharyngeal bolus transit in patients with anorexia nervosa. METHODS: The study was conducted with 8 individuals clinically diagnosed and in treatment for restricting-type anorexia nervosa (seven women and one man), and 14 healthy individuals with no digestive or neurological symptoms (10 women, 4 men)...
July 2016: Arquivos de Gastroenterologia
Christopher Cabib, Omar Ortega, Hatice Kumru, Ernest Palomeras, Natalia Vilardell, Daniel Alvarez-Berdugo, Desirée Muriana, Laia Rofes, Rosa Terré, Fermín Mearin, Pere Clavé
Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition...
July 11, 2016: Annals of the New York Academy of Sciences
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