Effects of Tongue-Hold Swallows on Suprahyoid Muscle Activation According to the Relative Tongue Protrusion Length in the Elderly Individuals

Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients

Objective

To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients.

Methods

Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS).

Results

The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%.

Conclusion

There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.

Dysphagia in amyotrophic lateral sclerosis: Quantification of bulbar motor dysfunction

BACKGROUND

Dysphagia as a sequel and possible early sign of amyotrophic lateral sclerosis (ALS) is caused by progressive impaired bulbar motor function.

OBJECTIVE

To evaluate bulbar motor dysfunction in patients suffering from ALS compared to a healthy reference group.

METHODS

A clinical study and prospective group comparison was designed. Patients and healthy volunteers were examined in the outpatient clinic of our university medical center. Ten patients with ALS and 20 healthy volunteers were included. All participants underwent a flexible endoscopic evaluation of swallowing (FEES) and a manometric measurement of the maximal sub-palatal atmospheric pressure generated by suction as well as of the prevalent pressure during swallowing. Additionally, the Sydney Swallow Questionnaire (SSQ) was completed by all participants to score the self-rated extent of dysphagia.

RESULTS

Comparing maximal suction pressures, the group of patients showed significantly lower values (p < .001). There was a significant correlation between reduced pressures and the degree of dysphagia (SSQ score) (r = -0.73).

CONCLUSIONS

As the oral cavity is an easily accessible compartment of the upper digestive tract, manometric measurements might serve as a simple instrument in order to detect or to monitor bulbar motor dysfunction. Oral manometry may facilitate early detection and monitoring of dysphagia in ALS. Larger studies are required to confirm our findings.