Image characteristics under videofluoroscope of dysphagia in stroke
- VernacularTitle:脑卒中后吞咽困难的影像学分析
- Author:
Jing ZHANG
;
Yongjun WANG
- Publication Type:Journal Article
- Keywords:
Cerebrovascular accident;
Deglutition disorders;
Fluoroscopy
- From:
Chinese Journal of Neurology
2000;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective Videofluoroscopy could identify the pathophysiologic changes of swallowing and be help to make management plan. The study was to identify image manifestation and characteristics of dysphagia in stroke under X-ray. Methods Videofluoroscopy were performed in 56 stroke inpatients and 30 healthy volunteers who drunk 1, 3 and 5 ml barium with viscosity of 60%w/v, 180%w/v and ate half piece of cake smeared with barium. Abnormal swallowing and quantitative measurements in antero-posterior and lateral position were recorded. Chi square test and Logistic regression analysis were used to identify abnormal swallowing associated with accidental aspiration. Rank test and t test were used to analysis the difference of quantitative measurements between control and accidental aspiration group. Results All the swallowing apparatus could be injured after stroke which led to a variety of abnormal oral and pharyngeal swallowing including decreased tongue and palate motility, insufficient glottis closure, delayed swallowing, accidental aspiration etc. All patients presented abnormality in pharyngeal phase and 46 in oral phase. Compared with that of volunteers, height and velocity of larynx elevation decreased, opening width of cricopharyngeal muscle reduced and swallowing latency prolonged in dysphagia patients. Accidental aspiration was seen in 34 patients, of whom 14 patients presented silent aspiration. Statistic analysis showed that decreased tongue movement(P=0.021), poor tongue-hard palate contact (P=0.021), insufficient glottis closure(P=0.011), decreased height and velocity of larynx elevation(P=0.003), delayed swallowing (P=0.001) and penetration (P=0.000) were associated with accidental aspiration. Conclusions Stroke may injure all the swallowing apparatus, more frequently in pharyngeal phase. Tongue weakness, insufficient glottis closure, poor larynx elevation, delayed swallowing and penetration are associated with accidental aspiration.
