Oropharyngeal swallowing function in patients with presbyphagia

Clinical significance of sarcopenic dysphagia for patients with esophageal cancer undergoing esophagectomy: A review

The relationships among esophagectomy for esophageal cancer, dysphagia, and sarcopenia are still unclear. We considered appropriate interventions for patients with resectable esophageal cancer for the purpose of reducing postoperative dysphagia and aspiration pneumonia. Dysphagia in patients with esophageal cancer is caused by patient characteristics, such as pathophysiology and age, or complications after esophagectomy. Recently, sarcopenic dysphagia, defined as dysphagia associated with whole‐body sarcopenia, has attracted attention in various fields, and a large proportion of patients with esophageal cancer are expected to have sarcopenic dysphagia. Our systematic review and meta‐analysis suggested that preoperative sarcopenia in patients with esophageal cancer is related to pulmonary complications after esophagectomy, and some reports also suggested that sarcopenia in swallowing‐related muscles, such as the geniohyoid muscle and tongue, might be associated with postoperative pneumonia or dysphagia after esophagectomy. However, clinical studies on sarcopenic dysphagia in patients with esophageal cancer have been limited. To prevent sarcopenic dysphagia after esophagectomy, perioperative interventions involving not only swallowing rehabilitation, but also physical exercise and nutritional support are important. Moreover, several reports have suggested that the chin‐down maneuver might be effective for preventing aspiration after an esophagectomy. To inhibit the progression of sarcopenic dysphagia after esophagectomy, evaluations and interventions by multidisciplinary staff are likely to be necessary.

THE DYSPHAGIA INVESTIGATION: IS THERE STILL SPACE FOR THE VIDEOFLUOROSCOPIC METHOD?

Dysphagia can lead to aspiration pneumonia, impacting the nutritional status and quality of life of the patient. The videofluoroscopy is highlighted for allowing both a real-time evaluation and the recording of the images for later review and analysis.

Olfactory Stimulation Successfully Improves Swallowing Function of Aged Rats through Activating Central Neuronal Networks and Downstream DHPR-RyR-mediated Neuromuscular Activities

Presbyphagia is age-related changes in swallowing function, which imposes a high risk of aspiration in older adults. Considering olfactory stimulation (OS) can influence behavioral activities by modulating neuronal excitability, the present study aims to determine whether OS could improve the swallowing function of aged rats through activating the central neuronal networks and downstream muscular activities participated in the control of swallowing. Aged male Wistar rats received OS by inhaling a mixture of plant-based volatile molecules twice a day for 12 days were subjected to functional magnetic resonance imaging (fMRI) and c-fos, choline acetyltransferase (ChAT) immunostaining to detect the neuronal activities of the orbitofrontal cortex (OFC) and medullary nuclei engaged in swallowing control, respectively. The functional effects of OS on downstream pharyngeal muscle activity were examined by evaluating the dihydropyridine receptor-ryanodine receptor (DHPR-RyR) mediated intra-muscular Ca2 + expression, and analyzing the amplitude/frequency of muscle contraction, respectively. In untreated rats, only moderate signal of fMRI and mild c-fos/ChAT expression was detected in the OFC and medullary nuclei, respectively. However, following OS, intense signals of fMRI and immunostaining were clearly expressed in the orbitofronto-medullary networks. Functional data corresponded well with above findings in which OS significantly enhanced DHPR-RyR-mediated intra-muscular Ca2 + expression, effectively facilitated a larger amplitude of pharyngeal muscle contraction, and exhibited better performance in consuming larger amounts of daily dietary. As OS successfully activates the neuromuscular activities participated in the control of swallowing, applying OS may serve as an effective, easy, and safe strategy to greatly improve the swallow function of aging populations.

Effects of Olfactory Stimulation on Swallowing Function in Taiwanese Older Adults

This pretest-posttest pilot study was to examine the effects of how olfactory stimulation (OS) influenced swallowing function in older adults. Forty-four community-dwelling older residents (24 OS & 20 control) from southern Taiwan were recruited. Participants in the intervention group administered pre-meal OS using odor and flavor inhalation. The study found that physiological responses for different food textures significantly differed between groups at post-test (p ≤ .02). Within the experimental group, swallowing function, and individual satisfaction showed significant differences before and after the odor inhalation over time (p < .01, ηp2 = 0.16–0.33). An individual’s satisfaction to their own swallowing capacity was largely enhanced by the significant interaction between time and group (F[1, 42] = 11.34, p = .002, ηp2 = 0.21), but not for physiological response to OS and swallowing function. The results suggest OS may be advantageous to improving physiological response to OS, swallowing function and satisfaction with swallowing capacity in older adults.