Abstract
Objectives
To investigate and compare the mechanism of swallowing with respect to the viscosity
of ingested material between patients with and without dysphagia.
Design
Prospectively collected and retrospectively analyzed clinical study.
Setting
General teaching hospital, rehabilitation unit.
Participants
We retrospectively reviewed the high-resolution manometry (HRM) results of 35 patients
with dysphagia symptoms (N=35). Additionally, we included 18 patients without dysphagia.
Based on videofluoroscopic swallowing study results, we classified the patients into
2 groups: one with aspiration and the other without aspiration.
Intervention
Swallowing of a 5-mL thin liquid and 5-mL honey-like liquid in all patients.
Main Outcome Measure
HRM of various variables during the swallowing process.
Results
There was no significant difference between the thin liquid and honey-like liquid
with respect to parameters for HRM in the patients without dysphagia and in the nonaspiration
and aspiration groups. However, in a comparison between thin liquid and honey-like
liquid with respect to visuospatial and timing variables, the degree of differences
in the maximal pressure of the velopharynx in the aspiration group was significantly
larger than the patients without dysphagia and the nonaspiration group (P<.05).
Conclusions
Our results indicate that there is a clear difference in the degree of adaptation
to viscosity between the 3 groups—patients without dysphagia, patients with aspiration,
and patients without aspiration. These differences may provide an explanation for
the mechanism of swallowing, which may be useful for the treatment of dysphagia.
Keywords
List of abbreviations:
HRM (high-resolution manometry), UES (upper esophageal sphincter), VFSS (videofluoroscopic swallowing study)To read this article in full you will need to make a payment
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References
- The correlation between manometric and videofluoroscopic measurements of the swallowing function in brainstem stroke patients with dysphagia.J Clin Gastroenterol. 2015; 49: 24-30
- Accommodation to changes in bolus viscosity in normal deglutition: a videofluoroscopic study.Ann Otol Rhinol Laryngol. 2001; 110: 1059-1065
- Kinematic analysis of dysphagia: significant parameters of aspiration related to bolus viscosity.Dysphagia. 2011; 26: 392-398
- Effects of bolus volume, viscosity, and repeated swallows in nonstroke subjects and stroke patients.Arch Phys Med Rehabil. 1993; 74: 1066-1070
- The effect of bolus viscosity on swallowing function in neurogenic dysphagia.Aliment Pharmacol Ther. 2006; 24: 1385-1394
- Changes of timing variables in swallowing of boluses with different viscosities in patients with dysphagia.Arch Phys Med Rehabil. 2013; 94: 120-126
- Effects of age, gender, bolus condition, viscosity, and volume on pharyngeal and upper esophageal sphincter pressure and temporal measurements during swallowing.J Speech Lang Hear Res. 2009; 52: 240-253
- Effects of age, gender, bolus volume, and bolus viscosity on oropharyngeal pressure during swallowing.J Appl Physiol (1985). 1993; 75: 33-37
- Automated analysis of pharyngeal pressure data obtained with high-resolution manometry.Dysphagia. 2011; 26: 3-12
- Findings of abnormal videofluoroscopic swallowing study identified by high-resolution manometry parameters.Arch Phys Med Rehabil. 2016; 97: 421-428
- The effects of bolus volume and texture on pharyngeal pressure events using high-resolution manometry and its comparison with videofluoroscopic swallowing study.J Neurogastroenterol Motil. 2016; 22: 231-239
- Effects of head rotation and head tilt on pharyngeal pressure events using high resolution manometry.Ann Rehabil Med. 2015; 39: 425-431
- A penetration-aspiration scale.Dysphagia. 1996; 11: 93-98
- Oesophageal high-resolution manometry: moving from research into clinical practice.Gut. 2008; 57: 405-423
- Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry.Otolaryngol Head Neck Surg. 2009; 141: 119-122
- Application and interpretation of high-resolution manometry for pharyngeal dysphagia.J Neurogastroenterol Motil. 2015; 21: 283-287
- Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition.Otolaryngol Head Neck Surg. 2013; 149: 126-133
- The national dysphagia diet: implementation at a regional rehabilitation center and hospital system.J Am Diet Assoc. 2003; 103: 381-384
- Dysphagia dietary guidelines and the rheology of nutritional feeds and barium test feeds.Chest. 2008; 133: 1397-1401
- Evaluation of dysphagia after cervical surgery using laryngeal electromyography.Dysphagia. 2012; 27: 318-324
- Videofluoroscopic swallowing study findings in full-term and preterm infants with dysphagia.Ann Rehabil Med. 2013; 37: 175-182
- Application of classification models to pharyngeal high-resolution manometry.J Speech Lang Hear Res. 2012; 55: 892-902
- Neural mechanisms of swallowing and effects of taste and other stimuli on swallow initiation.Biol Pharm Bull. 2010; 33: 1786-1790
- The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review.Dysphagia. 2015; 30: 2-26
- Noninvasive approaches to deglutitive aspiration.Dysphagia. 1993; 8: 331-333
Article info
Publication history
Published online: August 11, 2016
Footnotes
Current affiliation for Park, Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.
Supported by a Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, Information/Communication Technology, and Future Planning (grant no. NRF-2013R1A1A1004622).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
