Temporal Characteristics of Penetration and Aspiration in Patients with Severe Dysphagia Associated with Lateral Medullary Syndrome

Dai, Meng; Qiao, Jiao; Chen, Huayu; Shi, Zhonghui; Liu, Binbin; Dou, Zulin

doi:10.1007/s00455-023-10607-9

Cited by 4 publications

(3 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to impairment of the glossopharyngeal and vagus nerve functions, WS can cause impairment in more than one site of the swallowing mechanism. It is known to affect the pharyngeal phase of swallowing more and manifest with laryngopharyngeal paresis [1,2,8].…”

Section: Case Presentation and Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Severe Dysphagia in a Patient with Wallenberg Syndrome and Killian Jamieson Diverticulum: A Case Report

Cotaoco,

Goto,

Koyama

et al. 2024

Preprint

View full text Add to dashboard Cite

Introduction Lateral medullary syndrome (Wallenberg syndrome) and Killian Jamieson diverticulum are both conditions known to cause dysphagia. Here we present the first reported case of severe dysphagia due to Wallenberg syndrome and a Killian Jamieson diverticulum discovered incidentally during videofluoroscopic swallowing study. Case Presentation A 66-year-old male previously diagnosed with Wallenberg syndrome was referred to our hospital due to severe dysphagia. Pre-operative work-up revealed decreased left-sided pharyngeal contraction, left vocal fold paralysis, impaired laryngeal elevation, and poor upper esophageal sphincter relaxation during swallowing. Furthermore, on videofluoroscopic swallowing study, an incidental finding of a contrast-filled outpouching of the esophagus on the left, below the level of the cricopharyngeus, indicated the presence of a pharyngoesophageal diverticulum. The patient underwent bilateral cricopharyngeal myotomy with diverticulectomy, laryngeal suspension surgery, and tracheostoma revision. The diagnosis of a Killian Jamieson diverticulum was confirmed based on intra-operative findings, as the diverticular pouch was indeed seen to be located below the cricopharyngeal muscle. Conclusion For patients with severe dysphagia that does not improve with swallowing rehabilitation, swallowing improvement surgery is an option. It aims to improve pre-operatively identified dysfunctional sites in the swallowing mechanism. It is important to always consider pharyngoesophageal diverticula as a possible cause of dysphagia so as not to miss the diagnosis. In this patient’s case, diverticulectomy was necessary to ensure the best possible outcomes in terms of improving his dysphagia.

show abstract

Section: Case Presentation and Discussionmentioning

confidence: 99%

“…Lateral Medullary Syndrome, also known as Wallenberg Syndrome (WS), occurs due to occlusion of the posterior inferior cerebellar artery or vertebral artery [1,2]. It manifests with a wide array of symptoms, including dysphagia, due to involvement of the nucleus ambiguus and glossopharyngeal and vagus nerves [3].…”

Section: Introductionmentioning

confidence: 99%

Severe Dysphagia in a Patient with Wallenberg Syndrome and Killian Jamieson Diverticulum: A Case Report

Cotaoco,

Goto,

Koyama

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Oropharyngeal dysphagia is characterized by difficulty initiating a swallow, and it may be accompanied by penetration, aspiration, and a sensation of residual food remaining in the pharynx [ 7 ]. Penetration, a mild form of swallowing difficulty, means that a bolus enters the laryngeal vestibule but never reaches the level of the vocal folds; this condition generally clears spontaneously [ 8 ]. Aspiration is a severe condition of dysphagia caused by accidentally inhaling food or liquid through the vocal cords into the airway [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Development of an Artificial Intelligence Video Analysis-Based Web Application to Diagnose Oropharyngeal Dysphagia: A Pilot Study

Jeong,

Lee,

Lim

et al. 2024

Brain Sciences

View full text Add to dashboard Cite

The gold standard test for diagnosing dysphagia is the videofluoroscopic swallowing study (VFSS). However, the accuracy of this test varies depending on the specialist’s skill level. We proposed a VFSS-based artificial intelligence (AI) web application to diagnose dysphagia. Video from the VFSS consists of multiframe data that contain approximately 300 images. To label the data, the server separated them into frames during the upload and stored them as a video for analysis. Then, the separated data were loaded into a labeling tool to perform the labeling. The labeled file was downloaded, and an AI model was developed by training with You Only Look Once (YOLOv7). Using a utility called SplitFolders, the entire dataset was divided according to a ratio of training (70%), test (10%), and validation (20%). When a VFSS video file was uploaded to an application equipped with the developed AI model, it was automatically classified and labeled as oral, pharyngeal, or esophageal. The dysphagia of a person was categorized as either penetration or aspiration, and the final analyzed result was displayed to the viewer. The following labeling datasets were created for the AI learning: oral (n = 2355), pharyngeal (n = 2338), esophageal (n = 1480), penetration (n = 1856), and aspiration (n = 1320); the learning results of the YOLO model, which analyzed dysphagia using the dataset, were predicted with accuracies of 0.90, 0.82, 0.79, 0.92, and 0.96, respectively. This is expected to help clinicians more efficiently suggest the proper dietary options for patients with oropharyngeal dysphagia.

show abstract

The Respiratory-Swallow Coordination may be Related to Aspiration in Infratentorial Stroke Patients

Qiao,

Dai,

Sun

et al. 2024

Dysphagia

View full text Add to dashboard Cite

Temporal Characteristics of Penetration and Aspiration in Patients with Severe Dysphagia Associated with Lateral Medullary Syndrome

Cited by 4 publications

References 53 publications

Severe Dysphagia in a Patient with Wallenberg Syndrome and Killian Jamieson Diverticulum: A Case Report

Severe Dysphagia in a Patient with Wallenberg Syndrome and Killian Jamieson Diverticulum: A Case Report

The Development of an Artificial Intelligence Video Analysis-Based Web Application to Diagnose Oropharyngeal Dysphagia: A Pilot Study

The Respiratory-Swallow Coordination may be Related to Aspiration in Infratentorial Stroke Patients

Contact Info

Product

Resources

About