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Oropharyngeal deglutition in stable COPD
Babak Mokhlesi1, Jeri A Logemann, Alfred W Rademaker
1Division of Pulmonary and Critical Care, Northwestern University Medical School and the Veterans Administration Chicago Healthcare System-Lakeside Division, IL, USA. Babak_Mokhlesi@rush.edu
Chest
|February 9, 2002
Summary
This study found that patients with chronic obstructive pulmonary disease (COPD) and lung hyperinflation exhibit altered swallowing physiology. These changes may reduce aspiration risk but require further investigation, especially during exacerbations.
Area of Science:
- Pulmonary Medicine
- Swallowing Disorders
- Deglutition Physiology
Background:
- Chronic obstructive pulmonary disease (COPD) is often associated with lung hyperinflation.
- Altered respiratory mechanics in COPD may impact oropharyngeal swallowing.
- The relationship between COPD-related hyperinflation and swallowing function requires detailed examination.
Purpose of the Study:
- To investigate deglutition in stable patients diagnosed with COPD and lung hyperinflation.
- To compare swallowing patterns in COPD patients with healthy controls.
Main Methods:
- Prospective enrollment of 20 COPD patients with FEV(1) < or = 65% and TLC > or = 120% predicted.
- Videofluoroscopic evaluation of oropharyngeal swallowing.
- Comparison with 20 age- and sex-matched historical control subjects.
Main Results:
- COPD patients demonstrated significantly lower maximal laryngeal elevation during swallowing (p < 0.001).
- Patients with COPD utilized more frequent protective swallowing maneuvers, including longer airway closure duration and earlier laryngeal closure (p < 0.05).
- No tracheal aspiration was observed in either group; resting laryngeal position did not differ.
Conclusions:
- Hyperinflated COPD patients exhibit altered swallowing physiology.
- Protective swallowing alterations may mitigate aspiration risk in stable COPD.
- The utility of these maneuvers during COPD exacerbations is uncertain and warrants further research.