Increased age is an independent risk factor for radiographic aspiration and laryngeal penetration after thoracotomy for pulmonary resection

Keeling, W. Brent; Hernandez, Jonathan M.; Lewis, Vicki; Czapla, Melissa; Zhu, Weiwei; Garrett, Joseph; Sommers, K. Eric

doi:10.1016/j.jtcvs.2010.02.049

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…Furthermore, we demonstrated that these patients had a risk of respiratory morbidity and 90‐day mortality. Although it was not the objective of the study, older age was not significantly associated with a higher rate of swallowing disorders, contrary to what had been reported on by Keeling et al . This may be explained by the relatively small number of patients with aspiration in our study.…”

Section: Discussioncontrasting

confidence: 88%

“…estimated the incidence of aspiration at 17.8% following pulmonary resection, based on clinical history enhanced with dynamic videofluoroscopic esophagramography . The authors also described the importance of older age in the development of post‐operative aspiration, recommending the routine use of videofluoroscopic swallowing studies for all patients older than 67 years, before post‐operative food intake . In our study, aspiration was assessed at the bedside using a blue‐coloured water test and endoscopic assessment for all patients, symptomatic or not, allowing us to diagnose 18 of 250 patients (7.2%) with swallowing disorders, which is lower than in the Keeling et al .’s study .…”

Section: Discussionmentioning

confidence: 94%

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Usefulness of a routine endoscopic assessment of laryngeal lesions after lung cancer surgery

et al. 2017

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Background and objective: Laryngeal pathology following lung cancer surgery is associated with postoperative morbidity and mortality. The aim of our study was to evaluate the usefulness of routine endoscopic assessment. Methods: We prospectively evaluated vocal cord pathology using laryngeal endoscopy within 24 h postsurgery. Over 25 months, 276 patients underwent thoracic surgery. We excluded 26 patients with previous laryngectomy or vocal cord paralysis, early postoperative reintubation or patients who did not consent to an endoscopy. Endoscopic data were reported using a standardized procedure, recording vocal cord paralysis, swallowing disorders with aspiration, detected using a blue-coloured water test and vocal cord haematoma. Results: Among 250 patients, vocal cord paralysis was diagnosed in 13 patients (5.2%) and was associated with a higher rate of post-operative pneumonia (P = 0.03), post-operative bronchoscopy (P = 0.01), reintubation (P = 0.007) and a trend towards an increased 90-day mortality rate (P = 0.09). Swallowing disorders with aspiration were diagnosed in 18 patients (7.2%) and were associated with a higher rate of post-operative pneumonia (P = 0.007), postoperative bronchoscopy (P = 0.01), reintubation (P = 0.004) and 90-day mortality (P = 0.03). Vocal cord haematomas were diagnosed in 28 patients (11.2%) and were not associated with an increased post-operative morbidity or mortality. Conclusion: Post-operative endoscopic laryngeal assessment is effective for diagnosing laryngeal pathology following thoracic surgery. Routine laryngeal endoscopic assessment may detect clinically silent swallowing disorders early to allow prompt treatment, which may prevent respiratory complications.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 94%

Usefulness of a routine endoscopic assessment of laryngeal lesions after lung cancer surgery

et al. 2017

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“…Dysphagia is a common consequence of disease and aging, is associated with complications in pneumonia, and has a particularly high mortality and morbidity in older adults. [1][2][3][4][5] The bedside water swallowing test is commonly used for clinical evaluation of swallowing function, but is not sensitive enough to detect small age-related alterations in swallowing. [6][7][8][9] Recent studies have documented both the neurophysiological and clinical significance of the coordination of respiration with swallowing.…”

Section: Introductionmentioning

confidence: 99%

Aging‐related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non‐invasive measurement techniques

Wang

Chen

Chuang

et al. 2014

Geriatrics Gerontology Int

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Aim:Previous studies have shown that the process of swallowing changes with aging, a phenomenon known as presbyphagia. These subtle and subclinical age-related changes make older adults more vulnerable to dysphagia during disease insults. However, there are limited studies of the swallowing process in older adults, because measurements are typically invasive or require exposure to X-rays. In the present study, we used integrated noninvasive measurements to determine aging-related changes of swallowing, and in the coordination of swallowing and respiration for a population of healthy participants. Methods:The non-invasive system provided measurements of larynx movement with piezoelectric sensors, submental muscle activity with surface electromyography and respiration-swallowing coordination by measurement of nasal airflow. We recruited 112 healthy participants from the community, 35 in a young-age group (age 20-30 years), 38 in a middle-age group (age 31-50 years) and 39 in an old-age group (age 51-70 years). Results:The oropharyngeal swallowing parameters of the old-age group had delayed onset latency and longer swallowing apnea duration relative to the other groups, and these differences were greater for larger boluses. The middle-and old-age groups had less expiratory-expiratory respiratory phase pattern than the young-age group. The probability of piecemeal deglutition was highest in the old-age group and lowest in the young-age group. These results show that the phases of oropharyngeal swallowing and the coordination of swallowing with respiration gradually change with aging. Conclusions:We used integrated non-invasive measurements to document age-related changes in swallowing, and in the coordination of swallowing and respiration in healthy adults. Geriatr Gerontol Int 2015; 15: 736-744.

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“…Dysphagia is well known to occur as a complication of intrathoracic surgical procedures [1][2][3][4][5][6][7][8]. There are numerous reports of the investigation of postoperative dysphagia after cardiac operations [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Long-Lasting Dysphagia Developing After Thoracotomy for Pulmonary Resection: a Case Series

et al. 2016

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The purpose of this study was to retrospectively evaluate the severity and the characteristics of dysphagia using videofluoroscopic swallowing studies (VFSS) in long-lasting dysphagia patients developing after thoracotomy performed for pulmonary resection. Eleven patients (10 men and 1 woman, average age 67 ± 6.6 years; the average operation time in the patients was 507 min) were selected from among patients who developed dysphagia after undergoing thoracotomy for pulmonary resection between January 2009 and December 2012. The videofluoroscopic dysphagia scale (VDS) at 1 month postoperatively was used as a representative of parameters examined by the VFSS. The score on the functional oral intake scale (FOIS) was determined to evaluate the swallowing capacity at 1 and 3 months postoperatively. Most of the patients showed improvement of FOIS score at 3 months postoperatively. The patients showed mainly pharyngeal dysfunction. In spite of preserving the swallowing reflex, abnormalities of the residue in the vallecula and pyriform sinus and penetration were relatively frequent. Perioperative factors (age, %VC, FEV, operation time, length of ICU stay) and FOIS were investigated to determine their relationships with the VDS score. While it showed no relationship with the age, lung function, operation time, and length of ICU stay, the VDS score was found to be significantly associated with the FOIS score at 3 months postoperatively. Evaluation by VFSS after lung surgery is useful to predict the prognosis of swallowing difficulty.

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Increased age is an independent risk factor for radiographic aspiration and laryngeal penetration after thoracotomy for pulmonary resection

Cited by 12 publications

References 16 publications

Usefulness of a routine endoscopic assessment of laryngeal lesions after lung cancer surgery

Usefulness of a routine endoscopic assessment of laryngeal lesions after lung cancer surgery

Aging‐related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non‐invasive measurement techniques

Long-Lasting Dysphagia Developing After Thoracotomy for Pulmonary Resection: a Case Series

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