Evaluation and Treatment of Swallowing Disorders

Logemann, Jeri

doi:10.1044/nsshla_12_38

Cited by 564 publications

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“…Baseline videofluoroscopy was undertaken by a consultant radiologist and a speech and language therapist who were not connected with the study or the stroke rehabilitation unit. The method used was slightly modified from that of Logemann [10]. The area screened was from the teeth anteriorly, the posterior pharyngeal wall posteriorly, the soft palate superiorly, and just below the cricopharyngeus muscle inferiorly.…”

Section: Methodsmentioning

confidence: 99%

“…This has been partly due to the nonavailability of reliable objective assessment methods in the past that are required to evaluate minor changes in swallowing that may result from such interventions. The development of videofluoroscopic techniques in recent years has enabled detailed analysis of different phases of deglutition, including accurate measurement of transit times for the bolus to complete the pharyngeal swallow and detection of aspiration even in the absence of clinical signs [10][11][12][13].…”

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confidence: 99%

“…The swallowing process is complex and consists of three phases [10]. The oral phase is under voluntary control and involves the presentation of food and bolus preparation prior to swallowing.…”

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confidence: 99%

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Pharmacological Treatment of Dysphagia in Stroke

et al. 1998

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The pharynx is important for a normal swallow and it has been suggested that pharmacological agents may play a role in the management of pharyngeal dysphagia, but none have been formally evaluated. A pilot double-blind, placebo-controlled study was undertaken in 17 hospitalized patients with persistent dysphagia 2 weeks after stroke. Patients were randomized to treatment with slow-release nifedipine 30 mg orally (n = 8) or placebo (n = 9) following specialist swallowing assessment and videofluoroscopy to exclude severe dysphagia. Videofluoroscopy was repeated after 4 weeks of treatment. Fourteen patients (active 6, placebo 8) completed the study. Two patients died (active 1, placebo 1) and 1 patient in the active group had to be withdrawn because of progressive heart failure. Initial assessment showed impairment in the pharyngeal phase with delayed triggering of swallow, poor laryngeal elevation, and prolonged pharyngeal transit times in all patients. Silent aspiration was seen in 4 patients (active 2, placebo 2). Improvement in swallowing was seen in 8 patients (active 5, placebo 3) at the end of 4 weeks. There were significant changes in the pharyngeal transit time (mean -1.34 second; 95% C.I. -2.56, -0.11) and swallow delay (mean -1.91 seconds; 95% C.I. -3.58, -0.24) in the active group suggesting improvement in the initiation of pharyngeal contractions and reduction in the time taken for the bolus to transverse the pharynx. A similar change was not seen in the placebo group. It is suggested that pharmacological agents such as nifedipine may have a role in the management of stroke-related dysphagia and merit further investigation.

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Pharmacological Treatment of Dysphagia in Stroke

et al. 1998

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“…Hierbei kommt dem Kehlkopf durch seinen reflektorischen Verschluss die entscheidende Bedeutung der Sicherung der Atemwege zu [21]. Es ist in diesem Zusammenhang zu beachten, dass die Schluckstraße den Atemweg umgibt, der Atemweg also inmitten des Speisewegs durch den laryngealen Verschluss gesichert werden muss.Auf muskulären Dysfunktionen beruhende Dysphagien treten vorwiegend bei neurologischen Erkrankungen auf, die mit Bewegungsstörungen einhergehen [20]. Diese können kortikal oder pyramidal, z.…”

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“…Auf muskulären Dysfunktionen beruhende Dysphagien treten vorwiegend bei neurologischen Erkrankungen auf, die mit Bewegungsstörungen einhergehen [20]. Diese können kortikal oder pyramidal, z.…”

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The application of botulinum toxin in oromandibular, pharyngeal and laryngeal dystonia

Olthoff

Laskawi

2012

HNO

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Dystonias of the oral, pharyngeal and laryngeal muscles are potential causes of deglutitive, respiratory and communicative disorders. In addition to functional deficits such as dysphagia, dysarthria and dysphonia, social disadvantages may arise from the visible or audible manifestations. Treatment with botulinum toxin offers symptomatic and temporary therapeutic effects. Examples of applications in oromandibular dystonia, palatoclonus, dysphagia and laryngeal dystonia (e.g., spasmodic dysphonia) are described.

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The Effects of Breath-Holding on Vocal Fold Adduction

Donzelli¹,

Brady²

2004

Arch Otolaryngol Head Neck Surg

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Evaluation and Treatment of Swallowing Disorders

Cited by 564 publications

References 0 publications

Pharmacological Treatment of Dysphagia in Stroke

Pharmacological Treatment of Dysphagia in Stroke

The application of botulinum toxin in oromandibular, pharyngeal and laryngeal dystonia

The Effects of Breath-Holding on Vocal Fold Adduction

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