-
Gastroenterology Clinics of North... Jun 2001As the number of elderly in the population increases, decompensation of swallowing and airway protective mechanisms can create an increased health care burden. This... (Review)
Review
As the number of elderly in the population increases, decompensation of swallowing and airway protective mechanisms can create an increased health care burden. This article outlines the effect of aging on deglutitive function and esophageal and aerodigestive reflexes. Specific disorders in the elderly are discussed.
Topics: Aged; Aged, 80 and over; Aging; Deglutition; Deglutition Disorders; Esophageal Diseases; Humans; Peristalsis
PubMed: 11432295
DOI: 10.1016/s0889-8553(05)70185-0 -
Dysphagia Feb 2017Research using animal models has contributed significantly to realizing the goal of understanding dysfunction and improving the care of patients who suffer from... (Review)
Review
Research using animal models has contributed significantly to realizing the goal of understanding dysfunction and improving the care of patients who suffer from dysphagia. But why should other researchers and the clinicians who see patients day in and day out care about this work? Results from studies of animal models have the potential to change and grow how we think about dysphagia research and practice in general, well beyond applying specific results to human studies. Animal research provides two key contributions to our understanding of dysphagia. The first is a more complete characterization of the physiology of both normal and pathological swallow than is possible in human subjects. The second is suggesting of specific, physiological, targets for development and testing of treatment interventions to improve dysphagia outcomes.
Topics: Animals; Biomedical Research; Deglutition; Deglutition Disorders; Disease Models, Animal; Humans
PubMed: 28132098
DOI: 10.1007/s00455-016-9778-7 -
CoDAS 2014To present recent studies that used the ultrasound in the fields of Speech Language Pathology and Audiology, which evidence possibilities of the applicability of this... (Review)
Review
PURPOSE
To present recent studies that used the ultrasound in the fields of Speech Language Pathology and Audiology, which evidence possibilities of the applicability of this technique in different subareas.
RESEARCH STRATEGY
A bibliographic research was carried out in the PubMed database, using the keywords "ultrasonic," "speech," "phonetics," "Speech, Language and Hearing Sciences," "voice," "deglutition," and "myofunctional therapy," comprising some areas of Speech Language Pathology and Audiology Sciences. The keywords "ultrasound," "ultrasonography," "swallow," "orofacial myofunctional therapy," and "orofacial myology" were also used in the search.
SELECTION CRITERIA
Studies in humans from the past 5 years were selected. In the preselection, duplicated studies, articles not fully available, and those that did not present direct relation between ultrasound and Speech Language Pathology and Audiology Sciences were discarded.
DATA ANALYSIS
The data were analyzed descriptively and classified subareas of Speech Language Pathology and Audiology Sciences. The following items were considered: purposes, participants, procedures, and results.
RESULTS
We selected 12 articles for ultrasound versus speech/phonetics subarea, 5 for ultrasound versus voice, 1 for ultrasound versus muscles of mastication, and 10 for ultrasound versus swallow. Studies relating "ultrasound" and "Speech Language Pathology and Audiology Sciences" in the past 5 years were not found.
CONCLUSION
Different studies on the use of ultrasound in Speech Language Pathology and Audiology Sciences were found. Each of them, according to its purpose, confirms new possibilities of the use of this instrument in the several subareas, aiming at a more accurate diagnosis and new evaluative and therapeutic possibilities.
Topics: Deglutition; Humans; Mastication; Speech-Language Pathology; Ultrasonography; Voice
PubMed: 25590916
DOI: 10.1590/2317-1782/20142013086 -
Journal of Parkinson's Disease 2023Swallowing impairment, including altered physiology and aspiration, occur across the progression of Parkinson's disease (PD). The phase of respiration during which a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Swallowing impairment, including altered physiology and aspiration, occur across the progression of Parkinson's disease (PD). The phase of respiration during which a swallow is initiated has been linked to swallowing impairment and aspiration in cohorts with dysphagia following stroke and head and neck cancer treatment, but has been understudied in PD. If similar findings are shown in individuals with PD, the implications for swallowing assessment and treatment are significant.
OBJECTIVE
The aim of this systematic review and meta-analysis of literature was to examine respiratory-swallow coordination measures and potential implications on swallowing physiology in individuals with PD.
METHODS
An extensive search of 7 databases (PubMed, EMBASE, Central, Web of Science, ProQuest Dissertations & Theses, Scopus, and CINAHL) with predetermined search terms was conducted. Inclusion criteria were individuals with PD and the use of objective evaluations of respiratory-swallow coordination.
RESULTS
Of the 13,760 articles identified, 11 met the inclusion criteria. This review supports the presence of atypical respiratory swallow patterning, respiratory pause duration and lung volume at swallow initiation in individuals with PD. The meta-analysis estimated an occurrence of 60% of non-expiration-expiration and 40% of expiration-expiration respiratory phase patterns surrounding swallowing.
CONCLUSION
Although this systematic review supports the occurrence of atypical respiratory-swallow coordination in individuals with PD, the evidence is limited by the variability in the methods of data acquisition, analysis, and reporting. Future research examining the impact of respiratory swallow coordination on swallowing impairment and airway protection using consistent, comparable, and reproducible methods and metrics in individuals with PD is warranted.
Topics: Humans; Parkinson Disease; Deglutition; Deglutition Disorders; Respiration
PubMed: 37393516
DOI: 10.3233/JPD-230057 -
Dysphagia Oct 2017The 8-point Penetration-Aspiration Scale (PAS) was introduced to the field of dysphagia in 1996 and has become the standard method used by both clinicians and... (Review)
Review
The 8-point Penetration-Aspiration Scale (PAS) was introduced to the field of dysphagia in 1996 and has become the standard method used by both clinicians and researchers to describe and measure the severity of airway invasion during swallowing. In this article, we review the properties of the scale and explore what has been learned over 20 years of use regarding the construct validity, ordinality, intervality, score distribution, and sensitivity of the PAS to change. We propose that a categorical revision of the PAS into four levels of increasing physiological severity would be appropriate. The article concludes with a discussion of common errors made in the statistical analysis of the PAS, proposing that frequency distributions and ordinal logistic regression approaches are most appropriate given the properties of the scale. A hypothetical dataset is included to illustrate both the problems and strengths of different statistical approaches.
Topics: Deglutition; Deglutition Disorders; Humans; Severity of Illness Index
PubMed: 28534064
DOI: 10.1007/s00455-017-9809-z -
Dysphagia Jun 2019A major emphasis in the evaluation of swallowing is to identify physiological abnormalities in swallowing that contribute to or explain unsafe swallowing (i.e., ingested... (Review)
Review
A major emphasis in the evaluation of swallowing is to identify physiological abnormalities in swallowing that contribute to or explain unsafe swallowing (i.e., ingested material enters the trachea; post-swallow residue in the pharynx). Impairments in laryngeal vestibule closure are widely recognized as one of the major causes of unsafe swallowing, as it is the primary mechanism and first line of defense for preventing material from penetrating the airway during swallowing. However, this complex mechanism is often overlooked and understudied in swallowing research and dysphagia management. The purpose of this review is to promote a better understanding of the mechanism of laryngeal vestibule closure. We discuss where gaps in research exist and propose future directions for incorporating laryngeal vestibule closure as a primary outcome measure in swallowing research. Additionally, we propose that an increased knowledge of the mechanism of laryngeal vestibule closure will increase diagnostic accuracy and optimize dysphagia management for patients with dysphagia.
Topics: Biomechanical Phenomena; Deglutition; Deglutition Disorders; Female; Humans; Larynx; Male
PubMed: 30062547
DOI: 10.1007/s00455-018-9928-1 -
American Journal of Surgery Feb 1957
Topics: Deglutition; Deglutition Disorders; Humans
PubMed: 13394791
DOI: 10.1016/0002-9610(57)90765-1 -
Brazilian Journal of Otorhinolaryngology 2015Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance... (Review)
Review
INTRODUCTION
Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance imaging (fMRI).
OBJECTIVE
This critical qualitative review of the literature analyzed international scientific publications in the PubMed database that investigated the activation of the central nervous system in humans during the act of swallowing.
METHODS
This investigation was limited to articles that investigated adults older than 18 years, published in English or Portuguese, between January 2002 and December 2013. Publications that did not have access to the full text, that were repeated by overlapping keywords, case studies, literature reviews, letters to the editor, and those not directly related to the topic of the investigation were excluded.
RESULTS
A total of 649 articles were identified, of which 21 matched the inclusion criteria.
CONCLUSION
The main purpose of the manuscripts that investigate the swallowing process through fMRI were: to characterize swallowing in different pathologies; to compare swallowing in different age groups; to describe brain activation in different stimulation conditions. These studies indicate multiple cortical regions involved in swallowing control. Overall, the studies indicate that fMRI is a non-invasive and quantitative method that allows the investigation of characteristics that are quite often not clinically visible.
Topics: Deglutition; Deglutition Disorders; Humans; Magnetic Resonance Imaging
PubMed: 26394917
DOI: 10.1016/j.bjorl.2015.08.006 -
Annals of the New York Academy of... Dec 2020Swallowing complaints are common and may have significant consequences for nutrition and pulmonary health. Etiology varies and different aspects of the deglutitive... (Review)
Review
Swallowing complaints are common and may have significant consequences for nutrition and pulmonary health. Etiology varies and different aspects of the deglutitive system may be affected. A thorough assessment from the oral cavity to the stomach will provide physiologic information that enables specific targeted management plans to be devised. Although the swallow trajectory bridges anatomic areas, there has previously been a tendency to compartmentalize assessment and treatment by arbitrary anatomic boundaries. It is now clear that this approach fails to appreciate the complexity of swallow mechanics and that systems (oral, pharyngeal, esophageal, and pulmonary) are intertwined and codependent. Swallowing specialists from different backgrounds and with complementary skill sets form a multidisciplinary team that can provide insight and address multiple areas of management. With the advent of new tools for instrumental evaluation, such as manometry, targeted rehabilitative strategies can be informed by physiology, increased in precision and breadth, and assessed quantitatively. Surgical approaches have evolved toward endoscopic techniques, and food technology is expanding options in dietary management. The multidisciplinary team is core to managing this varied and often neglected patient population. This review is for clinicians treating swallowing disorders and will explore the selected aspects of the assessment and management of pharyngoesophageal swallowing disorders.
Topics: Deglutition; Esophageal Motility Disorders; Esophagus; Humans; Manometry; Oropharynx
PubMed: 32794195
DOI: 10.1111/nyas.14456 -
Otolaryngologic Clinics of North America Dec 1990Normal swallow involves a number of closely coordinated neuromuscular events. Investigators have identified some small temporal changes in the swallow of older adults as... (Review)
Review
Normal swallow involves a number of closely coordinated neuromuscular events. Investigators have identified some small temporal changes in the swallow of older adults as compared with young adults. Further research is needed to define completely the primary effects of aging on deglutition. Many medical conditions that commonly affect the elderly can cause dysphagia. These are discussed in terms of their effects on swallow physiology. Diagnosis and treatment of dysphagia in the elderly should be pursued as aggressively as in the younger adult.
Topics: Aging; Deglutition; Deglutition Disorders; Humans; Oropharynx
PubMed: 2074979
DOI: No ID Found