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*

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

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

Prevalence of dysphagia is one of the important epidemiological data which will contribute to the proper planning and support the setting up of a swallowing rehabilitation clinic at this hospital. The present study aimed to determine the prevalence of dysphagia in patients with head and neck cancer (HNC) at Hospital Universiti Sains Malaysia (Hospital USM) from 2001-2010. In this institutional retrospective study, a total of 66 records were obtained comprising of 86.4% Malay patients, 9.1% Chinese, 1.5% Indians, and 3% other ethnic groups. These data were taken from the database of HNC patients seen at the dental clinic, Hospital USM between 2001 and 2010. Difficulty swallowing, frequent coughing during meal, choking, diet modification, and non-oral nutritional support were identified as signs and symptoms associated with dysphagia. Results showed that 59.1% of patients have had dysphagia before, during, or after the treatment of HNC. Data from the present study would be instrumental in increasing awareness among clinicians involved in patient care and it may help in planning the outline of management of dysphagia. Furthermore, it is anticipated to have implications for further research in swallowing and dysphagia.
Deglutition Disorders ; Head and Neck Neoplasms ; Prevalence ; Deglutition

Neuromuscular electrical stimulation (NMES) has been increasingly used on dysphagic patients with the aim of improving their swallowing ability. However, there were insufficient clinical and basic knowledge of NMES in regard to the selection of stimulation parameters, which optimize improvement in swallowing-related muscular function. This review summarizes the results of clinical and basic researches in terms of acute and chronic physiologic effects of different stimulation protocols, explains the role of the various parameters of stimulation in determining the effect of NMES training protocols, and gives clinical recommendations for the selection of stimulation parameters. We speculate that this topic is important for medical doctors and therapists who want to investigate and practice NMES.
Deglutition Disorders ; Deglutition* ; Electric Stimulation* ; Humans