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Dysphagia: predicting laryngeal penetration.

P Linden, A A Siebens

    Archives of Physical Medicine and Rehabilitation
    |June 1, 1983
    PubMed
    Summary
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    Swallowing difficulties (dysphagia) often involve food or liquid entering the airway (laryngeal penetration). This study found motion fluoroscopy essential for diagnosis and tailored feeding strategies, especially with liquids.

    Area of Science:

    • Otolaryngology
    • Speech-Language Pathology
    • Gastroenterology

    Background:

    • Pharyngeal stage dysphagia presents significant challenges in swallowing.
    • Laryngeal penetration is a key concern in dysphagia management.
    • Clinical indicators for penetration are not always reliable.

    Purpose of the Study:

    • To investigate the occurrence of laryngeal penetration in patients with pharyngeal dysphagia.
    • To evaluate the correlation between clinical signs and penetration.
    • To determine the influence of bolus consistency on penetration.

    Main Methods:

    • Clinical assessment of 15 patients with pharyngeal dysphagia.
    • Motion fluoroscopy to visualize the swallowing process.
    • Analysis of clinical signs like gag reflex and voice quality.

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    Main Results:

    • Eleven of 15 patients showed laryngeal penetration during swallowing.
    • Impaired gag reflex and wet-hoarse voice were common but poorly correlated with penetration.
    • Cough was an unreliable indicator of penetration.
    • Penetration risk was highest with liquids and lowest with semisolids.

    Conclusions:

    • Motion fluoroscopy is crucial for reliably detecting laryngeal penetration.
    • Dysphagia is influenced by bolus characteristics, particularly consistency.
    • Fluoroscopic findings aid in planning appropriate feeding strategies for patients with dysphagia.