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Parkinson’s disease is associated with both swallowing and respiratory dysfunction, increasing the risk of aspiration and pneumonia. Previous studies have shown improvements in measurements of swallowing and respiration with levodopa; however, the studies are small and some studies show conflicting reports. The aim of this study was to further investigate the effect of levodopa on respiration. Ten...
Many people with Down’s syndrome (DS) experience eating, drinking, and swallowing (EDS) difficulties, which can potentially lead to life-threatening conditions such as malnutrition, dehydration, and aspiration pneumonia. As the life expectancy of people with DS continues to improve, there is an increasing need to examine how the aging process may further affect these conditions. Published research...
Pharyngocele is infrequently reported in the literature and is rarely considered in the differential diagnosis of upper dysphagia. We describe the case of a healthy young man, without any history of activities that would result in elevated intrapharyngeal pressure, with difficulty swallowing since childhood. Bilateral pharyngoceles were diagnosed after barium swallow and carbonated-beverage ingestion...
This study reports the viscosity (thickness) of nectar- and honey-thick liquids measured at a typical serving temperature. Centipoise (cP) measurements were compared for three products (two starch and one gum-based thickener) mixed with five beverages that set for three time intervals (manufacturer-recommended time to thicken, 10 min, and 30 min). The serving temperature of the cold beverages was...
We measured the oral and pharyngeal transit of a paste bolus in 20 patients with Chagas’ disease and 21 controls. Each subject swallowed of a 10-ml paste bolus prepared with 50 ml of water and 4.5 g of instant food thickener labeled with 55.5 MBq of 99m technetium phytate. After the scintigraphic recording of the transit, we delineated regions of interest (ROI) corresponding to mouth, pharynx, and...
There have been questions about the reliability of subjective rating scales used to assess valleculae residue from fluoroscopic images. The aim of this study was to assess interrater agreement on one such scale, and compare it with agreement using a new objective measurement scale. Five speech and language therapists rated 100 valleculae residue still images from 20 consecutive patients using standard...
Aspiration pneumonia is the leading cause of death in Parkinson’s disease (PD) patients. In clinical practice, the videofluoroscopic examination (VFE) is the most common method for evaluation of swallowing disorders. One of the variables manipulated during the VFE is consistency of the bolus. The results of this examination greatly influence the recommendations made by speech-language pathologists...
Disease-related atrophy of the tongue muscles can lead to diminished lingual strength and swallowing difficulties. The devastating physical and social consequences resulting from this condition of oropharyngeal dysphagia have prompted investigators to study the effects of tongue exercise in improving lingual strength. We developed the Madison Oral Strengthening Therapeutic (MOST) device, which provides...
This study aimed to verify if older patients admitted to a tertiary care geriatric ward with no spontaneous complaints of dysphagia have impaired swallowing function as detected by a specialized clinical assessment and a scintigraphic study of swallowing. Thirty patients (mean age = 76.2 years, 17 women), consecutively admitted for the treatment of acute or chronic diseases, were studied. Two control...
Previous literature on tongue-jaw relationships during swallowing has focused on behaviors observed with chewable solid foods. The present investigation was undertaken to evaluate both the nature and stability of coordinative relationships between the jaw and three points located along the midsagittal groove of the tongue—anterior (blade), middle (body), and posterior (dorsum)—during swallowing of...
The purpose of this study was to validate the Caregiver Mealtime and Dysphagia Questionnaire (CMDQ). The validation procedures included the following: (a) assessment of internal consistency reliability, (b) testing of approximations to normality, and (c) assessments of convergent and discriminant validity. Study participants were 85 noncompliant and 50 compliant caregivers. Factor analytical techniques...
The purpose of this study was to identify the videofluoroscopic prognostic factors that affect the recovery of swallowing function at an early stage after stroke and to make a tool for predicting the long-term prognosis. Eighty-three poststroke patients were selected prospectively. These patients had all undergone videofluoroscopic swallowing studies at an average of 40 days after stroke onset and...
A minor proportion of patients with achalasia eventually have a neoplasm and, as a consequence, pseudoachalasia is diagnosed. A neoplasm may either involve gastrointestinal junction or present a paraneoplastic effect. Over the global diagnoses of achalasia issued in 5 years of experience in our motility unit, we have found 13% (3/23 cases) of pseudoachalasia (2–4% in previous series, probably due...
Although stroke affects mainly the oral and pharyngeal phases of swallowing, it may also impair esophageal contractions. Our hypothesis is that stroke may affect esophageal transit. The oral, pharyngeal, and esophageal transit was studied by the scintigraphic method in 26 patients (age range = 26–83 years), eight of whom had mild dysphagia but all were able to feed orally and who had suffered an acute...
For many years different treatments have been used for achalasia. However, esophagomyotomy (ESM) and pneumatic balloon dilation (PBD) have been considered the treatments of choice. Despite new research, some controversies still exist. We compared patients who underwent open ESM (n = 19) with those who underwent PBD (n = 45). Data on age, gender, pre- and postprocedure symptoms, clinical manifestations...
Esophageal acid exposure induces sensory and motility changes in the upper gastrointestinal tract; however, the mechanisms involved and the effects on activity in the brain regions that control swallowing are unknown. The aim of this study was to examine functional changes in the cortical swallowing network as a result of esophageal acidification using functional magnetic resonance imaging (fMRI)...
This study was performed to establish the swallowing trigger by using the reaction time from an auditory stimulus. With this stable temporal starting point, we described the chronology of the different acoustic, electrophysiologic, and respiratory events that occurred during swallowing in a population of normal adults. We studied the swallowing reaction time (SRT) in 18 subjects aged 23 to 73 years...
The purpose of this study was to ascertain the effect of aging on muscle contractile properties associated with tongue protrusion in a rat model. Fischer 344/Brown Norway hybrid rats, ten young (9 months old) and ten old (32 months old), were used to measure protrusive contractile properties. Results showed a significant reduction in tetanic forces in the old animals. The following measures of muscle...
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