Effect of palatal augmentation prosthesis on pharyngeal manometric pressure in a patient with functional dysphagia: A case report

Ohno, Tomohisa; Ohno, Ryo; Fujishima, Ichiro

doi:10.1016/j.jpor.2017.01.006

Cited by 14 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well known that a PAP improves swallowing in postglossectomy patients (25). A clinical report indicated that the PAP increased pharyngeal pressure in a dysphagic patient with postoperative Bi-12N injury (21). The present results and clinical reports suggest that covering palates with dental AM may not only allow the recovery of oral and pharyngeal transit but also reverse the reduced swallowing pressure in patients with 12N or tongue damage.…”

Section: Discussionsupporting

confidence: 57%

“…A palatal augmentation prosthesis (PAP) is a palatal prosthetic device used to recover speech and swallowing functions of patients who have undergone glossectomy (25). Ohno et al also reported that a PAP improved swallowing pressure at the tongue base in a dysphagic patient with 12N injury (21). These clinical reports lead us to hypothesize that this apparatus not only helps recover oral function but reverses the reduced swallowing pressure in these patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure

Tsujimura

Suzuki

Yoshihara

et al. 2018

Journal of Applied Physiology

View full text Add to dashboard Cite

Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow, evoked by punctate mechanical stimulation to the larynx, was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG). Areas under the curve of the swallowing pressure at the OP, UES, and CE from two trials indicated high intrasubject reproducibility. Effects of transecting the hypoglossal nerve (12N) and recurrent laryngeal nerve (RLN) on swallowing were investigated. Following bilateral hypoglossal nerve transection (Bi-12Nx), OP pressure was significantly decreased, and time intervals between peaks of thyrohyoid EMG bursts and OP pressure were significantly shorter. Decreased OP pressure and shortened times between peaks of thyrohyoid EMG bursts and OP pressure following Bi-12Nx were significantly increased and longer, respectively, after covering the hard and soft palates with acrylic material. UES pressure was significantly decreased after bilateral RLN transection compared with that before transection. These results suggest that the 12N and RLN play crucial roles in OP and UES pressure during swallowing, respectively. We speculate that covering the palates with a palatal augmentation prosthesis may reverse the reduced swallowing pressure in patients with 12N or tongue damage by the changes of the sensory information and of the contact between the tongue and a palates. NEW & NOTEWORTHY Hypoglossal nerve transection reduced swallowing pressure at the oropharynx. Covering the hard and soft palates with acrylic material may reverse the reduced swallowing function caused by hypoglossal nerve damage. Recurrent laryngeal nerve transection reduced upper esophageal sphincter negative pressure during swallowing.

show abstract

Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure

Tsujimura

Suzuki

Yoshihara

et al. 2018

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

“…Immediate improvement was observed after balloon dilatation of the impaired UES. The devised plan included the creation of a palatal augmentation prosthesis (PAP) [ 12 , 13 ] to address oropharyngeal concerns and coaching for vacuum swallowing to eliminate pharyngeal residue during speech therapy.…”

Section: Case Presentationmentioning

confidence: 99%

A Case of a Patient With Spinal Muscular Atrophy With Dysphagia Who Acquired Vacuum Swallowing

Okamoto,

Kunieda,

Ohno

et al. 2024

Cureus

Self Cite

View full text Add to dashboard Cite

We present a case of acquired vacuum swallowing in a patient with spinal muscular atrophy associated with dysphagia. A 67-year-old male presented with spinal muscular atrophy. Even though he was able to eat orally, he required a long time to eat and faced difficulty while swallowing saliva, resulting in frequent spitting. Instructions regarding vacuum swallowing to eliminate pharyngeal residue were provided, and a reduction in meal duration and improved saliva swallowing were observed. High-resolution manometry revealed a significant increase in pharyngeal contractile integral and a significant decrease in esophageal pressure with vacuum swallowing, which enabled the passage of a bolus through the pharynx compared with non-vacuum swallowing. Furthermore, an increase in the lower esophageal sphincter pressure, reflecting diaphragmatic contraction, was also observed. Therefore, this case report elucidates that a patient with neuromuscular disorders could acquire vacuum swallowing with proper instructions.

show abstract

“…12 If tongue to palate contact is weak, a palatal augmentation prosthesis which artificially lowers the palatal vault enables the residual tongue volume or activity to contact the palate, 13 resulting in an improvement in bolus transportation and a decrease in the amount of oral and pharyngeal residues. 14 This reduces the aspiration risk after meals. A speech bulb prosthesis can be made to obturate palatal defect due to cancer resection to reduce nasal regurgitation.…”

Section: Dental Prostheses To Aid Oral Phase Dysphagiamentioning

confidence: 99%

Dentistry considerations for the dysphagic patient: Recognition of condition and management

Quek

Lee

2019

Proceedings of Singapore Healthcare

View full text Add to dashboard Cite

Dysphagia is a symptom of various underlying medical conditions. It can be attributed to age related changes, neurological, cognitive, respiratory and gastrointestinal diseases. These conditions may cause functional and anatomical changes along the swallowing tract. Impaired swallowing function and oromotor insufficiencies may result in inadvertent aspiration of fluids and/or particles during dental procedures. This article attempts to highlight the importance of identifying patients with dysphagia and discusses ways to reduce life threatening conditions that may arise during dental procedures.

show abstract

Effect of palatal augmentation prosthesis on pharyngeal manometric pressure in a patient with functional dysphagia: A case report

Abstract: A palatal augmentation prosthesis helps improve pharyngeal swallowing pressure at the basal tongue region and might contribute to the decrease of oral as well as pharyngeal residue.

Cited by 14 publications

References 10 publications

Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure

Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure

A Case of a Patient With Spinal Muscular Atrophy With Dysphagia Who Acquired Vacuum Swallowing

Dentistry considerations for the dysphagic patient: Recognition of condition and management

Contact Info

Product

Resources

About