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Investigation of compensatory postures with videofluoromanometry in dysphagia patients

World Journal of Gastroenterology 2012年第23期18卷 2973-2978页

作者： Antonio Solazzo Luigi Monaco Lucia Del Vecchio Stefania Tamburrini Francesca Iacobellis Daniela Berritto Nunzia Luisa Pizza Alfonso Reginelli Natale Di Martino Roberto Grassi Department of Radiology Magrassi-Lanzara Second University of Naples 80138 Napoli Italy Department of Gerontology Geriatrics and Metabolic Diseases Second University of Naples 80138 Napoli Italy Department of Pathology of the Head and Neck Oral Cavity and Audio-verbal Communication Second University of Naples 80138 Napoli Italy UOC Diagnostic Imaging PO Pellegrini 80134 Napoli Italy

AIM: To investigate the effectiveness of head compensatory postures to ensure safe oropharyngeal transit. METHODS: A total of 321 dysphagia patients were enrolled and assessed with videofluoromanometry (VFM). The dysphagia patients were classified as follows: safe transit; penetration without aspiration; aspiration before, during or after swallowing; multiple aspirations and no transit. The patients with aspiration or no transit were tested with VFM to determine whether compensatory postures could correct their swallowing disorder. RESULTS: VFM revealed penetration without aspiration in 71 patients (22.1%); aspiration before swallowing in 17 patients (5.3%); aspiration during swallowing in 32 patients (10%); aspiration after swallowing in 21 patients (6.5%); multiple aspirations in six patients (1.9%); no transit in five patients (1.6%); and safe transit in 169 patients (52.6%). Compensatory postures guaranteed a safe transit in 66/75 (88%) patients with aspiration or no transit. A chin-down posture achieved a safe swallow in 42/75 (56%) patients, a head-turned posture in 19/75 (25.3%) and a hyperextended head posture in 5/75 (6.7%). The compensatory postures were not effective in 9/75 (12%) cases. CONCLUSION: VFM allows the speech-language therapist to choose the most effective compensatory posture without a trial-and-error process and check the effectiveness of the posture.

关键词： Aspiration Compensatory postures Oro-pharyngeal dysphagia videofluoromanometry Chin-down posture Head-turned Hyperextended head

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