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Journal of the Korean Academy of Rehabilitation Medicine 1997;21(1):20-29.
The Effects of Posture and Bolus Viscosity on Swallowing in patients with Dysphagia.
Chung, Sun Gun , Lee, Seong Jai , Hyun, Jung Keun , Park, Seok Gun
1Department of Rehabilitation Medicine, College of Medicine, Dankok University, Korea.
2Department of Nuclear Medicine, College of Medicine, Dankok University, Korea.
연하곤란증환자에서 자세와 음식물 성상 변화에 따른 효과
정선근, 이성재, 현정근, 박석건*
단국대학교 의과대학 재활의학교실 및 핵의학교실*

The oropharyngeal swallow of 26 patients with dysphagia was studied quantitatively and qualitatively using videofluoroscope. Videofluoroscopic examination was done with head in neutral position, and with three different consistency of test meals; thin liquid, thick liquid, and solid. When aspiration or laryngeal penetration was noted in neutral position, the study was repeated with different head positions. We compared them with each other and with 25 normal subject(previously presented).

11/26(42%) patients revealed laryngeal penetration or aspiration at least with one consistency of test meal. Aspiration occurred more frequently in thin liquid than thick liquid or solid. Head position change successfully eliminated aspiration in 10/10 patient(100%). Other one patient could not change his head position.

9 numerical parameters were derived and calculated for quantitative examination. Liquid meal oral discharge time, pharyngeal delay time, and pharyngeal transit time were significantly increased in patients with aspiration than in patients without aspiration. Also significantly increased than those of normal controls.

Because different test meal consistency gave different values, direct comparison of values regardless of meal consistency was fruitless. And because all the process of swallowing cannot be expressed as numerical parameters, qualitative examination of videofluoroscopic result was essential.

In conclusion, liquid meal oral discharge time, pharyngeal delay time, and pharyngeal transit time were useful parameters in differentiating and quantifying dysphagia. Aspiration can be reduced when appropriate position assumed. Calculated values were different according to the consistency of the test meal. Quantitative analysis was helpful, but qualitative examination of videofluoroscopy was essential.

Key Words: Dysphagia, Posture, Viscosity, Oropharyngeal swallow, Videofluoroscopy


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