scholarly journals The Occurrence of Laryngeal Penetration and Aspiration in Patients with Glottal Closure Insufficiency

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Rajaei ◽  
Ebrahim Barzegar Bafrooei ◽  
Fariba Mojiri ◽  
Mohammad Hussein Nilforoush
Keyword(s):  
Early Interventions ◽  
Glottal Closure ◽  
Pharyngeal Phase ◽  
Laryngeal Penetration ◽  
Swallowing Evaluation ◽  
Dysphagic Patients ◽  
Incomplete Closure

Glottal closure during the pharyngeal phase of swallowing is one of the important steps in protecting the airway. Generally, it is believed that any deficiency in this process can lead to laryngeal penetration and aspiration. This study investigated the incidence of laryngeal penetration and aspiration among 44 patients with glottal closure insufficiencies that were referred for voice and swallowing evaluation to our institution. The videostroboscopy and 3 oz water swallow test were performed for all of the patients and dysphagic patients were screened and referred for videofluoroscopy. Overall, 15.90% of patients demonstrated signs of laryngeal penetration (13.63%) and aspiration (2.27%). The patients with the pattern of incomplete closure illustrated the highest percentage of penetration-aspiration (21.73%, 4.34%) among other GCI patterns. Thus, early interventions for these patients’ swallowing condition seem necessary.

scholarly journals Clinical evaluation of oropharyngeal dysphagia in Machado-Joseph disease

2010 ◽  
Vol 47 (4) ◽  
pp. 334-338 ◽  
Author(s):  
Sabrina Mello Alves Corrêa ◽  
Valter Nilton Felix ◽  
Jonas Lírio Gurgel ◽  
Rubens A. A Sallum ◽  
Ivan Cecconello
Keyword(s):  
Clinical Evaluation ◽  
Clinical Characteristics ◽  
Oropharyngeal Dysphagia ◽  
Neurological Manifestations ◽  
Severity Scale ◽  
Pharyngeal Phase ◽  
History Of ◽  
Machado Joseph Disease ◽  
Dysphagic Patients

CONTEXT: In Machado-Joseph disease, poor posture, dystonia and peripheral neuropathy are extremely predisposing to oropharyngeal dysphagia, which is more commonly associated with muscular dystrophy. OBJECTIVE: To evaluate the clinical characteristics of oropharyngeal dysphagia in Machado-Joseph disease patients. METHOD: Forty individuals participated in this study, including 20 with no clinical complaints and 20 dysphagic patients with Machado-Joseph disease of clinical type 1, who were all similar in terms of gender distribution, average age, and cognitive function. The medical history of each patient was reviewed and each subject underwent a clinical evaluation of deglutition. At the end, the profile of dysphagia in patients with Machado-Joseph disease was classified according to the Severity Scale of Dysphagia, as described by O'Neil and collaborators. RESULTS: Comparison between dysphagic patients and controls did not reveal many significant differences with respect to the clinical evaluation of the oral phase of deglutition, since afflicted patients only demonstrated deficits related to the protrusion, retraction and tonus of the tongue. However, several significant differences were observed with respect to the pharyngeal phase. Dysphagic patients presented pharyngeal stasis during deglutition of liquids and solids, accompanied by coughing and/or choking as well as penetration and/or aspiration; these signs were absent in the controls. CONCLUSIONS: Oropharyngeal dysphagia is part of the Machado-Joseph disease since the first neurological manifestations. There is greater involvement of the pharyngeal phase, in relation to oral phase of the deglutition. The dysphagia of these patients is classified between mild and moderate.

Videomanometry of the pharynx in dysphagic patients with laryngeal barium penetration during swallowing

1998 ◽  
Vol 39 (4) ◽  
pp. 405-409 ◽  
Author(s):  
R. Olsson ◽  
J. Castell ◽  
O. Ekberg ◽  
D. O. Castell
Keyword(s):  
Healthy Volunteers ◽  
Peak Pressure ◽  
Oropharyngeal Dysphagia ◽  
Barium Swallow ◽  
Mean Values ◽  
Contraction Duration ◽  
Laryngeal Penetration ◽  
Resting Pressure ◽  
Laryngeal Vestibule ◽  
Dysphagic Patients

Purpose: This study used simultaneous videomanometry to measure pressure characteristics in a group of patients with evidence of laryngeal and/or tracheal barium penetration, and to compare the results to those of one group of healthy volunteers and one group of patients with dysphagia but a normal barium swallow. Material and Methods: Videomanometry during barium swallowing was performed in 25 patients who showed penetration of barium into the laryngeal vestibule. Manometric abnormalities were determined by comparing these mean values with those of 25 healthy volunteers, and the frequency of manometric abnormalities was compared to that of 19 patients presenting with oropharyngeal dysphagia with a normal barium swallow. Results: The frequency of abnormalities for four parameters (pharyngo-eso-phageal segment (PES) resting pressure, PES relaxation duration, pharyngeal peak pressure, pharyngeal contraction duration) differed significantly between the patients with penetration and those with normal barium studies. There was, however, no association between manometric abnormalities and the degree of barium penetration. Conclusion: The differences in manometric abnormalities between patients with laryngeal penetration and patients with normal barium swallows may be useful in identifying the mechanisms of laryngeal penetration.

Glottal Closure and Perceived Breathiness During Phonation in Normally Speaking Subjects

1990 ◽  
Vol 33 (3) ◽  
pp. 601-611 ◽  
Author(s):  
Maria Södersten ◽  
Per-Åke Lindestad
Keyword(s):  
Interaction Effects ◽  
Glottal Closure ◽  
Incomplete Closure

Glottal closure and perceived breathiness were evaluated in 9 female and 9 male normally speaking subjects ranging in age from 20 to 35 years. Phonations of the vowel /i:/ at three loudness and pitch levels were performed. The degree of glottal closure was judged by speech clinicians from video-fiberstroboscopic recordings. Later they rated the degree of perceived breathiness both in the vowels recorded during the fiberscopy and in separately tape-recorded vowels. Intra- and interjudge reliabilities were satisfactory. The degree of incomplete glottal closure and the degree of perceived breathiness were significantly higher for the women than for the men. For both sexes, the degree of incomplete closure and perceived breathiness increased significantly as an effect of decreased loudness. Neither the degree of closure nor the perceived breathiness were significantly affected by changes in pitch or by interaction effects. It was concluded that incomplete glottal closure of the posterior parts of glottis should be regarded as normal primarily in women and that loudness should be taken into consideration when studying glottal closure and breathiness.

Glottal Gap Configurations in Two Age Groups of Women

1992 ◽  
Vol 35 (6) ◽  
pp. 1209-1215 ◽  
Author(s):  
Sue Ellen Linville
Keyword(s):  
Elderly Women ◽  
Age Groups ◽  
The Elderly ◽  
Common Type ◽  
Glottal Closure ◽  
High Incidence ◽  
Pitch Level ◽  
Incomplete Closure ◽  
Two Age Groups

The purpose of this study was to gather data on glottal gap configurations in two age groups of women. Using videostroboscopy, glottal closure patterns of 20 women (10 young, 10 elderly) were observed across nine pitch/loudness conditions. While both young and elderly speakers displayed a high incidence of glottal gaps, the two groups differed markedly in the configuration of the gaps observed and in the phonatory conditions under which gaps were observed. Young speakers demonstrated posterior chink and incomplete closure significantly more frequently than elderly women, although rarely demonstrating anterior gap or spindle configuration. In contrast, anterior gap was the single most common type of gap in the elderly, with spindle also occurring significantly more frequently. Individual elderly speakers, overall, changed glottic configuration more frequently across phonatory conditions than did young speakers. Some individual elderly speakers tended to vary glottic configuration consistently with pitch level changes.

Early Interventions to Minimize Delinquency

1992 ◽  
Author(s):  
E. Zigler ◽  
C. Taussig ◽  
K. Black
Keyword(s):  
Early Interventions

Effect of Neuromuscular Electrical Stimulation on Swallowing Process in Stroke Patient with Neurogenic Dysphagia

1970 ◽  
Vol 1 (1) ◽  
pp. 44-53
Author(s):  
Ruth Ariyani ◽  
Widjajalaksmi ◽  
Luh K Wahyuni ◽  
Susyana Tamin ◽  
Saptawati Bardosono
Keyword(s):  
Electrical Stimulation ◽  
Voice Quality ◽  
Neuromuscular Electrical Stimulation ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Cough Reflex ◽  
Voluntary Cough ◽  
Pharyngeal Phase ◽  
Significant Difference ◽  
Quasi Experimental

Objective: The aim of this study to determine the therapeutic effect of Neuromuscular Electrical Stimulation (NMES) on pharyngeal phase of swallowing for stroke patients with neurogenic dysphagia,and to see the effect of NMES in reducing the incidence of standing secretion, residue, penetration and aspiration.Methods: It is a quasi-­experimental study design. 10 stroke patients with neurogenic dysphagia in Cipto Mangunkusumo hospital, Jakarta, 40-­80 years old with hemodynamically stable, cooperative and will be get NMES therapy for 4 weeks. Pre and Post treatment assessment caompared using a modified MASA test (The Mann Assessment of Swallowing Ability) and FEES examination (Flexible Endoscophic Evaluation of Swallowing). Analysis of change scores using Wilcoxon test.Results:The obtain average age of patients 59.80+9.705 years. Significant difference seen in the pharyngeal phase of swallowing increased score of gag reflex, velum elevation, cough reflex, voluntary cough, voice quality, pharynx response, pharyngeal constrictor contraction and vocal cord adduction (p<0.005).Also seen significant reduction in the incidence of standing secretion, residue and penetration (p<0.005), but not significantly in the incidence of aspiration (p=0083).Conclusions: NMES increased the pharyngeal phase of swallowing, reduced the incidence of standing secretion, residue and penetration of stroke patients with neurogenic dysphagia, but have not able to reduced aspiration.Keywords :Neuromuscular Electrical Stimulation (NEMS), neurogenic dysphagia, MASA test (The Mann Assessment of Swallow ing Ability), FEES examination (Flexible Endoscophic Evaluation of Swallowing), swallowing process.

Clinical evaluation of Triphala Ghruta Akshitarpana in the management of Ardita (Bell’s Palsy)

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Lodha Sheetal Ganeshlalji
Keyword(s):  
Clinical Evaluation ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Study Objective ◽  
Incomplete Closure ◽  
Specific Amount

Ardita is one of the Vata Vyadhi. Management of Ardita is same as Vata Vyadhi. It includes Nasya, Murdhnitala, Basti. Karnapurana and Akshitarpana. Akshitarpana is a unique procedure where medicated ghee is retained over the eyes for a specific amount of time. Ardita can be correlated with Bell’s palsy. Symptoms like incomplete closure of eye, watering of eye, deviation of mouth, forehead creases loss, earache, dribbling of saliva, heaviness of face, taste loss, hyperacusis are same. In this study efficacy of Akshitarpan is evaluated in Ardita. Triphala Ghruta is selected to do Akshitarpan. Subjective criteria for assessment are watering of eye, deviation of mouth, forehead creases loss, earache, dribbling of saliva, heaviness of face, taste loss, hyperacusis. Total 30 patients were taken for study. Objective criteria for assessment is incomplete closure of eye. Accurate tests are applied to data. Study reveals that Triphala Ghruta Akshitarpana has effect on only 2 symptoms of Ardita. i.e. Incomplete closure of eye and watering of eye.

scholarly journals Parents’ Perceptions of Early Interventions and Related Services for Children with Autism Spectrum Disorder in Saudi Arabia

2016 ◽  
Vol 9 (10) ◽  
pp. 128 ◽  
Author(s):  
Faihan Alotaibi ◽  
Nabil Almalki
Keyword(s):  
Autism Spectrum Disorder ◽  
Saudi Arabia ◽  
Early Intervention ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Interventions ◽  
Related Services ◽  
Children With Asd ◽  
The Government

<p class="apa">The present study sought to examine parents’ perceptions of early interventions and related services for children with autism spectrum disorder (ASD) in Saudi Arabia. In this study a survey was distributed to a sample of 80 parents with children who have ASD. Parents also were asked open-ended questions to enable them to provide suggestions. The findings indicate that parents have varying perceptions of early interventions and related services. However, they seem to agree that these services are important in assisting their children. Accordingly, parents have suggested that the government needs to increase these services by providing more centers for children with ASD in Saudi Arabia, providing more specialists to deal with children with ASD, promoting inclusion in regular schools and providing more information on early intervention.</p>

scholarly journals Mixed Consistencies in Dysphagic Patients: A Myth to Dispel

Dysphagia ◽  
2021 ◽  
Author(s):  
Mozzanica Francesco ◽  
Pizzorni Nicole ◽  
Scarponi Letizia ◽  
Bazzotti Claudia ◽  
Ginocchio Daniela ◽  
...  
Keyword(s):  
Rating Scale ◽  
Pyriform Sinus ◽  
Endoscopic Evaluation ◽  
Pharyngeal Residue ◽  
Food Residue ◽  
Severity Rating ◽  
Vegetable Soup ◽  
Laryngeal Vestibule ◽  
Dysphagic Patients ◽  
Penetration Aspiration Scale

AbstractOnly limited and inconsistent information about the effect of mixed consistencies on swallowing are available. The aim of this study was to evaluate the location of the head of the bolus at the swallow onset, the risk of penetration/aspiration, and the severity of post-swallow pharyngeal residue in patients with dysphagia when consuming mixed consistencies. 20 dysphagic patients underwent a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) testing five different textures: liquid, semisolid, solid, biscuits-with-milk and vegetable-soup. The location of the head of the bolus at the onset of swallowing was rated using a five-points scale ranging from zero (the bolus is behind the tongue) to four (the bolus falls into the laryngeal vestibule), the severity of penetration/aspiration was rated using the Penetration Aspiration Scale (PAS), the amount of pharyngeal residue after the swallow was rated using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) in the vallecula and pyriform sinus. When consuming biscuits-with-milk and liquid the swallow onset occurred more often when the boluses were located in the laryngeal vestibule. Penetration was more frequent with biscuits-with-milk, while aspiration was more frequent with Liquid, followed by biscuits-with-milk and vegetable-soup, Semisolid and Solid. In particular, no differences in penetration and aspiration between liquids and biscuits-with-milk were found as well as among vegetable-soup, semisolid and solid. No significant differences in the amount of food residue after swallowing were demonstrated. The risk of penetration-aspiration for biscuits-with-milk and liquid is similar, while the risk of penetration-aspiration is lower for vegetable-soup than for liquid.

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