Suckle facilitation of feeding in selected adult dysphagic patients

Abstract

Abstract. The use of a valved feeding line and nipple is reported as an aid in reinstituting oral feeding in adults rendered dysphagic by composite resections or oral and submandibular structures. Suckle feeding procedures that have proven useful in these situations have also been applied with varying success to selected adults rcndcrcd dysphagic by ncurological impairments. The success of preliminary investigations warrants further investigation of suckle feeding as an adjunct to conventional rehabilitative therapies.The armamentarium and training exercises employed in suckle feeding are described. The necessity for confirmatory cineradiographic or videofluoroscopic records of swallowing function is emphasized.

An intraoral stent to improve examination of swallowing in a case involving gunshot wound to the face

“…This is mainly due to the patient's inability to retain the oral sphincter seal to form a bolus, and to transport the bolus, resulting in drooling and aspiration. To improve the conduct of modified barium swallow cxams, "'head tilt," suckle feeding, or straw delivery of thc contrast medium has been advocated [2,3,5,6]. Although successful in other cases [2], application of "head tilt" and straw suckling technique resuited, in our case, in excessive drooling and aspiration followed by violent cough.…”

“…To facilitate swallowing, various tech~l! involving body positioning, suckle feeding, o~ struction of special devices have been propO~ alleviate dysphagia and drooling [2,5,6].…”

Management: General principles and guidelines

“…For patients with severe oral cavity deficits, prosthetic intervention can be invaluable. These interventions attempt to normalize the shape of the oral cavity, allowing the remaining tongue residual to make contact against the prosthesis to achieve the pressure relationships necessary for better speech and bolus propulsion [7,8].…”

Clinical Signs, Symptoms and Treatment of Dysphagia in the Neurologically Disabled

“…Suckle feeding has also been shown to be a strategic alternative resource in patients with neurogenic dysphagia exhibiting failure of elicitation of pharyngeal swallow (39). During early human development, the neuroanatomic and neurophysiologic basis for swallowing changes and dramatic evidence has been presented to show that some severely dysphagic adults can feed safely by reverting to infant-patterned suckle feeding (40,41 (42,43), cerebrovascular accident (44,45), head injury (46), and Amytrophic Lateral Sclerosis (47,48 Challenging clinical problems of feeding are frequently encountered in neurologic patients who temporarily or permanently require mechanically-assisted respiration (27,50).…”