Dysphagia
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Comparative Study
Simultaneous videoradiography and pharyngeal solid state manometry (videomanometry) in 25 nondysphagic volunteers.
Recent technological advances in manometry, including solid state transducers and computerized analysis, allows for reliable interpretation of intraluminal pharyngeal pressures. Simultaneous videoradiography (barium swallow) provides fluoroscopic control of the manometric sensors (videomanometry), thereby eliminating the uncertainty of sensor dislocation during laryngeal elevation. This is the first study describing normal manometric parameters in videomanometry during barium swallow. ⋯ A specific finding was discovered when the epiglottis tilts down hitting the manometric sensor. This epiglottic tilt was identified in 7 subjects (28%) and caused pressures of around 600 mmHg. A standardized manometric technique is important in videomanometry, and normal values as described in this study are essential in clinical use.
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Review Comparative Study
Indications and techniques of endoscopy in evaluation of cervical dysphagia: comparison with radiographic techniques.
The technique of fiberoptic endoscopic evaluation of swallowing disorders (FEES), and a comparison of its utility with that of videofluoroscopic examination in patients with dysphagia, was presented in a workshop session. Viewpoints were expressed by two speech pathologists and an otolaryngologist experienced in assessment and treatment of patients with dysphagia, and representative cases, illustrated with videotaped FEES and videofluoroscopic studies, were discussed. Some of the major advantages and disadvantages of each of these modalities are discussed in the following three articles.
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The dysphagia team is often faced with the dilemma of whether or not to let patients with known aspiration feed orally. The criteria that assist professionals in their final decisions may be more anecdotal than empirical. ⋯ For some dysphagia teams, the presence of tracheal penetration of swallowed contents is sufficient indication to preclude oral feeding. For others, some amounts of aspiration are acceptable.
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Frequency response characteristics of six popular stethoscopes are reported for the higher frequency range (to 3000 Hz) to supplement equivalent measurements for the lower frequencies (35-1000 Hz) published previously. Spectra of the sounds of swallowing from the throat, transduced with an accelerometer, demonstrate important frequency composition in this higher range. Two stethoscope models were found to have superior transmission characteristics for use in cervical auscultation of swallowing sounds.
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Review Comparative Study
Effect of aging on the deglutitive oral, pharyngeal, and esophageal motor function.
Aging affects some members of the swallowing orchestra and spares the others. It seems that changes in the pharynx of the elderly are more of a positive nature than a negative one and reflect an adaptation to age-induced structural changes of the upper esophageal sphincter. ⋯ In the upper esophageal sphincter, it appears that aging reduces the resting pressure, but spares its response to various stimuli. Considering the increasing elderly population and their medical needs, further normalcy data about various manometric aspects of deglutition is needed for physiologic studies as well as diagnostic and therapeutic purposes.