Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction

Hideaki Miyaji, Toshiro Umezaki, Kazuo Adachi, Motohiro Sawatsubashi, Hideyuki Kiyohara, Takashi Inoguchi, Satoshi To, Shizuo Komune

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives/Hypothesis: The pathophysiology of dysphagia caused by brain infarction varies with the site of the lesion in the brain. Patients with suprabulbar lesions have demonstrated delayed triggering of pharyngeal stage including delayed laryngeal elevation. Patients with severe pharyngeal stage delay have a high risk of intractable aspiration to the lower respiratory tract. Despite this, few studies have compared the pharyngeal stage delay with the lesion site. We defined a new temporal parameter of the pharyngeal stage delay to assess laryngeal elevation delay against the bolus inflow into the pharyngeal space. This study aimed to elucidate whether this parameter of pharyngeal stage delay is clinically useful to assess the pathophysiology of brain lesions after brain infarction. Study Design: Case-control study. Methods: Videofluoroscopic assessment of swallowing examinations was performed from January 7, 2000 to March 29, 2011 at Kyushu University Hospital. We evaluated the pharyngeal stage delay using motion analysis on videofluoroscopic swallowing examination in patients with normal swallowing and brain infarction patients divided into pathophysiologic lesion groups. Laryngeal elevation delay time and pharyngeal delay time were analyzed. Results: Significant differences in laryngeal elevation delay time were observed between each pathophysiologic lesion group. However, pharyngeal delay time remained similar among groups. Brain infarctions of corticobulbar tract and basal ganglion were significantly associated with laryngeal elevation delay time prolongation. Conclusions: Laryngeal elevation delay time with low-viscosity contrast medium is a recommended parameter to discriminate the corticobulbar tract and the basal ganglion lesion.

Original languageEnglish
Pages (from-to)2793-2799
Number of pages7
JournalLaryngoscope
Volume122
Issue number12
DOIs
Publication statusPublished - Dec 1 2012

Fingerprint

Brain Infarction
Deglutition
Pyramidal Tracts
Basal Ganglia
Brain
Deglutition Disorders
Viscosity
Respiratory System
Contrast Media
Case-Control Studies

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

Miyaji, H., Umezaki, T., Adachi, K., Sawatsubashi, M., Kiyohara, H., Inoguchi, T., ... Komune, S. (2012). Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction. Laryngoscope, 122(12), 2793-2799. https://doi.org/10.1002/lary.23588

Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction. / Miyaji, Hideaki; Umezaki, Toshiro; Adachi, Kazuo; Sawatsubashi, Motohiro; Kiyohara, Hideyuki; Inoguchi, Takashi; To, Satoshi; Komune, Shizuo.

In: Laryngoscope, Vol. 122, No. 12, 01.12.2012, p. 2793-2799.

Research output: Contribution to journalArticle

Miyaji, H, Umezaki, T, Adachi, K, Sawatsubashi, M, Kiyohara, H, Inoguchi, T, To, S & Komune, S 2012, 'Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction', Laryngoscope, vol. 122, no. 12, pp. 2793-2799. https://doi.org/10.1002/lary.23588
Miyaji H, Umezaki T, Adachi K, Sawatsubashi M, Kiyohara H, Inoguchi T et al. Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction. Laryngoscope. 2012 Dec 1;122(12):2793-2799. https://doi.org/10.1002/lary.23588
Miyaji, Hideaki ; Umezaki, Toshiro ; Adachi, Kazuo ; Sawatsubashi, Motohiro ; Kiyohara, Hideyuki ; Inoguchi, Takashi ; To, Satoshi ; Komune, Shizuo. / Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction. In: Laryngoscope. 2012 ; Vol. 122, No. 12. pp. 2793-2799.
@article{01b8e55376944bde81b6d3071b701897,
title = "Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction",
abstract = "Objectives/Hypothesis: The pathophysiology of dysphagia caused by brain infarction varies with the site of the lesion in the brain. Patients with suprabulbar lesions have demonstrated delayed triggering of pharyngeal stage including delayed laryngeal elevation. Patients with severe pharyngeal stage delay have a high risk of intractable aspiration to the lower respiratory tract. Despite this, few studies have compared the pharyngeal stage delay with the lesion site. We defined a new temporal parameter of the pharyngeal stage delay to assess laryngeal elevation delay against the bolus inflow into the pharyngeal space. This study aimed to elucidate whether this parameter of pharyngeal stage delay is clinically useful to assess the pathophysiology of brain lesions after brain infarction. Study Design: Case-control study. Methods: Videofluoroscopic assessment of swallowing examinations was performed from January 7, 2000 to March 29, 2011 at Kyushu University Hospital. We evaluated the pharyngeal stage delay using motion analysis on videofluoroscopic swallowing examination in patients with normal swallowing and brain infarction patients divided into pathophysiologic lesion groups. Laryngeal elevation delay time and pharyngeal delay time were analyzed. Results: Significant differences in laryngeal elevation delay time were observed between each pathophysiologic lesion group. However, pharyngeal delay time remained similar among groups. Brain infarctions of corticobulbar tract and basal ganglion were significantly associated with laryngeal elevation delay time prolongation. Conclusions: Laryngeal elevation delay time with low-viscosity contrast medium is a recommended parameter to discriminate the corticobulbar tract and the basal ganglion lesion.",
author = "Hideaki Miyaji and Toshiro Umezaki and Kazuo Adachi and Motohiro Sawatsubashi and Hideyuki Kiyohara and Takashi Inoguchi and Satoshi To and Shizuo Komune",
year = "2012",
month = "12",
day = "1",
doi = "10.1002/lary.23588",
language = "English",
volume = "122",
pages = "2793--2799",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "12",

}

TY - JOUR

T1 - Videofluoroscopic assessment of pharyngeal stage delay reflects pathophysiology after brain infarction

AU - Miyaji, Hideaki

AU - Umezaki, Toshiro

AU - Adachi, Kazuo

AU - Sawatsubashi, Motohiro

AU - Kiyohara, Hideyuki

AU - Inoguchi, Takashi

AU - To, Satoshi

AU - Komune, Shizuo

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Objectives/Hypothesis: The pathophysiology of dysphagia caused by brain infarction varies with the site of the lesion in the brain. Patients with suprabulbar lesions have demonstrated delayed triggering of pharyngeal stage including delayed laryngeal elevation. Patients with severe pharyngeal stage delay have a high risk of intractable aspiration to the lower respiratory tract. Despite this, few studies have compared the pharyngeal stage delay with the lesion site. We defined a new temporal parameter of the pharyngeal stage delay to assess laryngeal elevation delay against the bolus inflow into the pharyngeal space. This study aimed to elucidate whether this parameter of pharyngeal stage delay is clinically useful to assess the pathophysiology of brain lesions after brain infarction. Study Design: Case-control study. Methods: Videofluoroscopic assessment of swallowing examinations was performed from January 7, 2000 to March 29, 2011 at Kyushu University Hospital. We evaluated the pharyngeal stage delay using motion analysis on videofluoroscopic swallowing examination in patients with normal swallowing and brain infarction patients divided into pathophysiologic lesion groups. Laryngeal elevation delay time and pharyngeal delay time were analyzed. Results: Significant differences in laryngeal elevation delay time were observed between each pathophysiologic lesion group. However, pharyngeal delay time remained similar among groups. Brain infarctions of corticobulbar tract and basal ganglion were significantly associated with laryngeal elevation delay time prolongation. Conclusions: Laryngeal elevation delay time with low-viscosity contrast medium is a recommended parameter to discriminate the corticobulbar tract and the basal ganglion lesion.

AB - Objectives/Hypothesis: The pathophysiology of dysphagia caused by brain infarction varies with the site of the lesion in the brain. Patients with suprabulbar lesions have demonstrated delayed triggering of pharyngeal stage including delayed laryngeal elevation. Patients with severe pharyngeal stage delay have a high risk of intractable aspiration to the lower respiratory tract. Despite this, few studies have compared the pharyngeal stage delay with the lesion site. We defined a new temporal parameter of the pharyngeal stage delay to assess laryngeal elevation delay against the bolus inflow into the pharyngeal space. This study aimed to elucidate whether this parameter of pharyngeal stage delay is clinically useful to assess the pathophysiology of brain lesions after brain infarction. Study Design: Case-control study. Methods: Videofluoroscopic assessment of swallowing examinations was performed from January 7, 2000 to March 29, 2011 at Kyushu University Hospital. We evaluated the pharyngeal stage delay using motion analysis on videofluoroscopic swallowing examination in patients with normal swallowing and brain infarction patients divided into pathophysiologic lesion groups. Laryngeal elevation delay time and pharyngeal delay time were analyzed. Results: Significant differences in laryngeal elevation delay time were observed between each pathophysiologic lesion group. However, pharyngeal delay time remained similar among groups. Brain infarctions of corticobulbar tract and basal ganglion were significantly associated with laryngeal elevation delay time prolongation. Conclusions: Laryngeal elevation delay time with low-viscosity contrast medium is a recommended parameter to discriminate the corticobulbar tract and the basal ganglion lesion.

UR - http://www.scopus.com/inward/record.url?scp=84871279668&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871279668&partnerID=8YFLogxK

U2 - 10.1002/lary.23588

DO - 10.1002/lary.23588

M3 - Article

C2 - 22965906

AN - SCOPUS:84871279668

VL - 122

SP - 2793

EP - 2799

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 12

ER -