No abstract available.
Deglutition Disorders*

No abstract available.
Deglutition Disorders*

No abstract available.
Deglutition Disorders*

There were critical limitations to dysphagia services in Malaysia with speech-language pathologists’ (SLPs) reported lacking skills and confidence in managing the disorder. This study examined the impact of providing professional development training in dysphagia management. Aims were to determine if: (1) delivery of a training series enhances SLPs knowledge in dysphagia management, (2) knowledge translated into improved clinical skills and (3) clinicians’ perception of their knowledge, skills and confidence improved post-training. The study used a single cohort pre- and post-test research design and involved nine Malaysian SLPs. Participants underwent assessment at pre- and immediately post-training and again at one month post-training. At each assessment level, knowledge and skills were assessed via a written examination and observational assessment of clinical performance respectively. Visual analogue scales were used to measure clinician’s perceptions of knowledge, skills and confidence. The training model involved four consecutive; 4-hour week-end workshops with opportunity to apply new knowledge and develop networking in clinical practice in the weekdays between each session. Significant (p < 0.05) improvements in knowledge and clinical skills were observed immediately post- and at one month after training. Clinician’s perceptions of knowledge, skills and confidence were also significantly higher immediately post- and at one month post-training. The current 4-week structured professional development model was found to be effective in enhancing SLPs’ knowledge and skills in dysphagia management and improving their perceptions and confidence. The findings highlight the benefits that can be achieved through well designed professional development programs.
Deglutition Disorders

A 64-year-old man presented with prolonged history of intermittent dysphagia with sensation of food sticking at his upper chest. Physical examination was unremarkable, and an upper endoscopy did not reveal the underlying cause. On computed tomography scan of thorax, an aberrant right subclavian artery was seen coursing posterior to the esophagus resulting in external compression, which is a typical radiological feature of Dysphagia Lusoria. The pathophysiology, clinical features, imaging features and updated treatment modalities of this rare disease are discussed.
Deglutition Disorders

No abstract available.
Deglutition Disorders*

OBJECTIVE: To investigate the inter-rater agreement for the clinical dysphagia scale (CDS). METHOD: Sixty-seven subjects scheduled to participate in a video-fluoroscopic swallowing study (VFSS) were pre-examined by two raters independently within a 24-hour interval. Each item and the total score were compared between the raters. In addition, we investigated whether subtraction of items showing low agreement or modification of rating methods could enhance inter-rater agreement without significant compromise of validity. RESULTS: Inter-rater agreement was excellent for the total score (intraclass correlation coefficient (ICC): 0.886). Four items (lip sealing, chewing and mastication, laryngeal elevation, and reflex coughing) did not show excellent agreement (ICC: 0.696, 0.377, 0.446, and kappa: 0.723, respectively). However, subtraction of each item either compromised validity, or did not improve agreement. When redefining 'history of aspiration' and 'lesion location' items, the inter-rater agreement (ICC: 0.912, 0.888, respectively) and correlation with new videofluoroscopic dysphagia score (PCC: 0.576, 0.577, respectively) were enhanced. The CDS showed better agreement and validity in stroke patients compared to non-stroke patients (ICC: 0.917 vs 0.835, PCC: 0.663 vs 0.414). CONCLUSION: The clinical dysphagia scale is a reliable bedside swallowing test. We can improve inter-rater agreement and validity by refining the 'history of aspiration' and 'lesion location' item.
Deglutition ; Deglutition Disorders ; Humans ; Mastication ; Reflex ; Stroke

Pediatric dysphagia comes from disturbances in swallowing process, which has 'preparatory phase', 'oral phase', 'pharyngeal phase', and 'esophageal phase', and mainly the causes are neuro-muscular discoordination. It is necessary to recognize clinical manifestation if they have accompanied organic disorder and diagnose accurately. Videofluoroscopic study evaluation is a valuable method to find out abnormal swallowing mechanism at each phases. Treatment should be diagnosis specific, and multidisciplinary team approach is desirable. We can use various behavioral techniques to facilitate normal swallowing mechanism including conditioning of oral and pharyngeal structures, bolus manipulation, postural compensation, and adaptive feeding utensils. Important point is that the diagnosis and treatment for pediatric dysphagia should not be delayed because children are under development.
Child ; Compensation and Redress ; Deglutition ; Deglutition Disorders ; Humans

Purpose: To report on a case of dysphagia secondary to botulinum toxin ingestion. Method: Case report Result: A 30-year-old female with no comorbidities, presented with dysphagia associated with ptosis and diplopia 12 hours after ingestion of double dead pork. Probable diagnoses of a neurologic, esophageal problem or a neoplasm were initially considered. Ancillary procedures to support diagnoses were performed including esophagogastroduodenoscopy, cranial CT scan and Facial and Extremity Nerve Conduction Velocity which all revealed unremarkable results. A possible polyneuropathy specifically foodborne toxicity was considered given a history of dysphagia, ptosis and diplopia with consumption of double dead pork. Confirmatory stool culture studies revealed Clostridium botulinum, hence appropriate antibiotics and supportive therapy were provided which led to the patient's recovery. Conclusion Early diagnosis and a high index of suspicion is important in cases with unfamiliar presentations, therefore a careful history and physical examination is warranted. Foodborne botulinum toxicity is a public health matter that should be addressed. Proper food handling and storage must always be practiced.
Public Health ; Deglutition Disorders ; Deglutition Disorders ; Botulism

OBJECTIVE: To study the application value of surface electromyography in children with dysphagia. METHODS: A total of 20 children with dysphagia were enrolled as the observation group, and 20 healthy children, matched for sex and age, were enrolled as the control group. Surface electromyography was used to record the electromyography integral values of the submental and infrahyoid muscle groups in the resting state and the state after water swallowing. The two groups were compared in terms of the electromyography integral values of the submental and infrahyoid muscle groups in the resting state and the state after swallowing 5 mL water. The observation group was observed in terms of the changes in the electromyography integral values of the submental and infrahyoid muscle groups after 1 month of rehabilitation treatment. A Spearman correlation analysis was used to evaluate the correlation of the degree of dysphagia with the electromyography integral values of the submental and infrahyoid muscle groups in the observation group. RESULTS: There was no significant difference between the two groups in the electromyography integral values of the submental and infrahyoid muscle groups in the resting state (P>0.05), while after water swallowing, the observation group had significantly higher electromyography integral values than the control group (P<0.05). The observation group had significant improvements in the clinical symptoms of dysphagia after treatment, with significant reductions in the electromyography integral values of the submental and infrahyoid muscle groups (P<0.05). The severity of dysphagia was positively correlated with the electromyography integral values of the submental and infrahyoid muscle groups (P<0.01). CONCLUSIONS Surface electromyography is useful in the diagnosis and therapeutic effect evaluation for dysphagia in children.
Child ; Deglutition ; Deglutition Disorders ; Electromyography ; Humans