Oropharynx in patients with cerebrovascular disease: evaluation with videofluoroscopy

Forty-six patients with cerebrovascular disease underwent videofluoroscopic examination of the oropharynx to assess location and severity of swallowing dysfunction with use of boluses of various consistencies. Low- and high-viscosity barium suspensions, a barium paste, and a paste-coated cookie were used; not all patients were given all materials. Thirty-nine patients had abnormalities of both oral and pharyngeal function. Two patients had oral dysfunction only, and five had pharyngeal abnormalities only. Mild swallowing difficulties occurred in 18 patients (39%), moderate dysfunction in 23 (50%), and severe dysfunction in five (11%). Thirty-one patients had pharyngeal stasis, which was symmetric in 25 patients (81%), right-sided in three, and left-sided in three. Asymmetric stasis did not correlate to the site of cerebrovascular disease. Twenty-four episodes of aspiration occurred, half of them with the low-viscosity barium suspension. Thus, video-fluoroscopy can be used to define the location and severity of oropharyngeal abnormalities, which is critical for feeding recommendations. The abnormalities present, however, were not useful in predicting the type of cerebrovascular disease.