Article

OBJECTIVES: To evaluate the timing of the swallowing process and the effect of
bolus viscosity on swallowing. DESIGN: Prospective observational study. SETTING:
General teaching hospital, rehabilitation unit. PARTICIPANTS: We enrolled
patients with dysphagia (n=82) in a videofluoroscopic swallowing study (VFSS)
from January 13, 2009, to October 22, 2009. Based on VFSS results, we classified
patients as "thin-fluid aspirators" (n=40) or as "nonaspirators" (n=42).
INTERVENTIONS: Swallowing of a 5-mL thick bolus and a 5-mL thin bolus in all
patients. MAIN OUTCOME MEASURES: Kinematic analysis of various variables during
the swallowing process (pharyngeal phase), including epiglottis contact with the
bolus, laryngeal elevation, pharyngeal constriction, and upper esophageal
sphincter opening. RESULTS: In both groups, the thin bolus arrived at the
vallecular pouch earlier than the thick bolus. During swallowing of the thick
bolus, the thin-fluid aspirators had a delayed latency of upper esophageal
sphincter opening, delayed laryngeal elevation to peak level, and significantly
longer rise time of laryngeal elevation. CONCLUSIONS: Our results indicate clear
differences in the degree of adaptation to bolus viscosity between patients
classified as thin-fluid aspirators and as nonaspirators. These differences were
mainly in activities of laryngeal elevators rather than pharyngeal constrictors.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS