THE REPETITIVE SALIVA SWALLOWING TEST AS A SCREENING TEST OF FUNCTIONAL DYSPHAGIA
K. Qgachi, E. Saitoh, M.Baba, M. Mizuno, M. Okui, & T. Tanaka (Fujita Health University, Aichi, Japan)
We have been developing a new method "Repetitive Saliva Swallowing Test (RSST)" to screen patients with functional dysphagia more simply and safely. In this test, subjects are asked to repeat forced dry swallowing and artificial saliva swallowing, whose counts are determined. The timing of swallowing is confirmed by inspection and palpation of the elevation of the larynx and by the surface EMG of the laryngeal elevator. The subjects of this test were healthy elderlies and young adults with no clinical evidence of dysphasia.
The elderlies had lower counts than young adults in swallowing per 30 seconds, 5.7±2.1 and 7.6±1.8 respectively. The results suggested the decreased performance of swallowing function in elderly. We will report normal values and the results of the reliability study on the RSST.
RADIOLOGICAL ASSESSMENT OF SWALLOWING DISORDERS IN PATIENTS WITH CEREBROVASCULAR ACCIDENT AND CRANIAL TRAUMA
G.Bertoni, F.Abelli (Department of Radiology), C.Pistarini, A.Contardi (Department of Neurorehabilitation) S.Maugeri Foundation, Montescano Medical Center - Italy
A striking increase has recently been observed in the survival rates of patients suffering from neuromuscular disease, cerebrovascular disorders, or sequelae of cerebral injuries and neurosurgical operations. These patients often suffer from swallowing disorders which may cause evident problems, such as aspiration into air passages, but which may also cause so-called "silent disphagia" which is often underestimated. The aim of this study was to evaluate swallowing disorders and their evolution after rehabilitation treatment in a group of 12 patiens with cerebrovascular accident (6 in brainstem + 6 in cerebral hemisphere ) and another group of 12 patients with cranial trauma.
The diagnosis of swallowing disorderes was based on Videofluorography (VFG) and rehabilitation treatment on Logemann's tecnique. All patients exhibited a variety of disturbances usually occurring in combination rather then as isolated disorders. The most frequent problem was a delayed swallowing reflex which was found in all patients of the groups. This fact may reflect the importance of cortical as well as brainstem input to the triggering of the swallowing reflex. Nevertheless some important differences appeared in the groups: the great majority of cranial trauma patients exhibited a severe reduced tongue control while a reduced laryingeal closure was present only in brainstem's vascular lesions. The rehabilitation treatment determined a complete recovery of swallowing in 6/24 patients (25%) and seems to present a significant improvement, but not complete recovery of initial swallowing deficit in the remaining patients.