Relationship Between Tongue Pressure and Pharyngeal Function Assessed Using High-Resolution Manometry in Older Dysphagia Patients with Sarcopenia: A Pilot Study

Kunieda, Kenjiro; Fujishima, Ichiro; Wakabayashi, Hidetaka; Ohno, Tomohisa; Shigematsu, Takaaki; Itoda, Masataka; Oshima, Fumiko; Mori, Takashi; Ogawa, N; Ogawa, Sumito

doi:10.1007/s00455-020-10095-1

Cited by 46 publications

(27 citation statements)

References 34 publications

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“…However, this study found no significant association between these disorders and the recovery of oral intake. Recent studies have reported that pharyngeal clearance is likely to decrease in patients with sarcopenia due to the enlarged pharyngeal cavity, 11 weaker pharyngeal contractility and upper oesophageal sphincter TA B L E 2 Comparison between the oral feeding group and the tube feeding group 12 However, we did not take the data of sarcopenia-related items in this study. Therefore, it is necessary to further investigate the association between sarcopenia and oral intake recovery in patients with aspiration pneumonia in the future.…”

Section: Oba Et Al Reported That the Glasgow Coma Scale And Repetitivementioning

confidence: 92%

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Kimura

Nakayama

Ogawa

et al. 2020

J of Oral Rehabilitation

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Objective: To verify the validity of the prediction of oral intake recovery for inpatients with aspiration pneumonia using the Hyodo-Komagane score. Background: Patients admitted for treatment of aspiration pneumonia sometimes have difficulty in resuming oral intake due to decreased swallowing function. Predicting whether the swallowing function will recover enough to achieve oral ingestion at discharge is an important factor in developing a treatment strategy. No studies have investigated the prediction of oral intake recovery using videoendoscopic examination. Methods: Subjects were 65 patients who were admitted to an acute care hospital for the treatment of aspiration pneumonia. The patients were divided into two groups, the oral feeding group and the tube feeding group, according to their oral intake status at discharge or transfer. Logistic regression analysis was performed using the condition that tube feeding was not required as an objective variable and the items with significant differences between the two groups as explanatory variables. Additionally, the receiver operating characteristic curve was used to identify patients who could take food orally at discharge. Results: The odds ratios for the Hyodo-Komagane score and the pharyngeal clearance score were 1.485 and 3.379, respectively. When the cutoff values of the Hyodo-Komagane score and the pharyngeal clearance score were 6 and 1, the sensitivity was 0.88 and 0.91, and the specificity was 0.64 and 0.70, respectively. Conclusion: The Hyodo-Komagane score and especially the pharyngeal clearance score are useful indices to predict oral intake recovery for inpatients with aspiration pneumonia. K E Y W O R D S aspiration pneumonia, dysphagia, oral intake, oral rehabilitation, predict, videoendoscopic How to cite this article: Kimura M, Nakayama E, Ogawa Y, et al. Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo-Komagane score in Japan.

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Section: Oba Et Al Reported That the Glasgow Coma Scale And Repetitivementioning

confidence: 92%

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Kimura

Nakayama

Ogawa

et al. 2020

J of Oral Rehabilitation

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“…Patients incapable of having their tongue pressure measured were included in possible sarcopenic dysphagia. Although the diagnostic algorithm defined the patients with tongue pressure >20 kPa as possible sarcopenic dysphagia, various factors could affect swallowing 21 . Possible sarcopenic dysphagia may include patients with no sarcopenic dysphagia more, compared with probable sarcopenic dysphagia.…”

Section: Methodsmentioning

confidence: 99%

Digastric muscle mass and intensity in older patients with sarcopenic dysphagia by ultrasonography

Ogawa

Wakabayashi

Mori

et al. 2020

Geriatrics Gerontology Int

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AimThe aim of this study was to investigate digastric muscle mass and intensity between no sarcopenic dysphagia and sarcopenic dysphagia.MethodsPatients aged ≥65 years were enrolled. According to the diagnostic algorithm for sarcopenic dysphagia, the patients were divided into two groups, no sarcopenic dysphagia and sarcopenic dysphagia. Handgrip strength, gait speed, skeletal muscle mass, tongue pressure, Mini Nutritional Assessment‐Short Form and Food Intake LEVEL Scale were investigated. Digastric muscle mass and intensity were examined by ultrasonography. Univariate and multivariate analyses were performed to analyze two groups. Multivariate logistic regression analysis was performed to determine independent factors for the presence of sarcopenic dysphagia. To estimate the accuracy of diagnosing sarcopenic dysphagia, a receiver operating characteristic curve analysis was performed for digastric muscle mass and intensity.ResultsForty‐five patients (mean ± SD, 84.3 ± 7.8 years, 22 men, 23 women) including 19 no sarcopenic dysphagia and 26 sarcopenic dysphagia were examined. In sarcopenic dysphagia, lower BMI, Food Intake LEVEL Scale, Mini Nutritional Assessment‐Short Form and smaller muscle mass and greater muscle intensity were found compared with no sarcopenic dysphagia. In multivariate logistic regression analysis, digastric muscle mass and intensity were identified as independent factors for sarcopenic dysphagia. The cut‐off value of muscle mass was 75.1 mm2 (area under curve: 0.731, sensitivity: 0.692, specificity: 0.737) and muscle intensity was 27.8 (area under curve: 0.823, sensitivity: 0.923, specificity: 0.632).ConclusionsDigastric muscle mass was smaller and muscle intensity was greater in sarcopenic dysphagia than no sarcopenic dysphagia. Ultrasonography of digastric muscle, as well as the tongue and geniohyoid muscle, is useful. Geriatr Gerontol Int 2021; 21: 14–19.

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“…Tsujimura et al 8 reported that hypoglossal nerve transection reduced swallowing pressure at the oropharynx. However, few reports have described relationships between reduction in tongue pressure and the state or movements of the pharyngeal organs during the pharyngeal phase of swallowing 9,10 …”

Section: Introductionmentioning

confidence: 99%

“…However, few reports have described relationships between reduction in tongue pressure and the state or movements of the pharyngeal organs during the pharyngeal phase of swallowing. 9,10 The tongue muscles provide the tongue muscle strength needed for swallowing function and are striated muscles of somatic origin.…”

Section: Introductionmentioning

confidence: 99%

Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: A cross‐sectional study of outpatients with dysphagia

Nagashima

Kikutani

Miyashita

et al. 2020

J of Oral Rehabilitation

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Background Tongue muscle strength is important for swallowing but decreases with age, in association with reduced skeletal muscle mass. However, the relationships between pharyngeal dynamics and both skeletal muscle mass and tongue muscle strength are unknown. Objective To investigate the effect of reductions in tongue muscle strength on pharyngeal movement during swallowing in patients with dysphagia. Methods Subjects were selected from male outpatients ≥65 years old who were examined for the main complaint of dysphagia. Patients with history of neurodegenerative disease affecting tongue movement, cerebrovascular disease or oral cancer were excluded. As a result, 82 men (mean age, 80.6 ± 6.8 years) participated. Skeletal muscle mass index (SMI) as physical parameters and maximum tongue pressure (MTP) as tongue muscles strength were measured. Status and dynamics of the pharyngeal organs, including change in posterior pharyngeal wall advancement (PPWA) when swallowing 3.0 mL of moderately thick liquid, were measured by analysing videofluoroscopic images. Simple bivariate correlation and multiple regression analysis were used to statistically analyse correlations between parameters. Results MTP showed a significant positive correlation with SMI (r = .43, P < .01). PPWA showed a significant negative correlation with MTP (r = −0.30, P < .01), but no association with SMI. Conclusions While tongue muscle strength is affected by skeletal muscle mass, posterior pharyngeal wall advancement is not readily affected by decreases in skeletal muscle mass. Posterior pharyngeal wall advancement may increase to compensate for swallowing function among individuals with reduced tongue muscle strength.

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Relationship Between Tongue Pressure and Pharyngeal Function Assessed Using High-Resolution Manometry in Older Dysphagia Patients with Sarcopenia: A Pilot Study

Cited by 46 publications

References 34 publications

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo‐Komagane score in Japan

Digastric muscle mass and intensity in older patients with sarcopenic dysphagia by ultrasonography

Tongue muscle strength affects posterior pharyngeal wall advancement during swallowing: A cross‐sectional study of outpatients with dysphagia

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