Association between pharyngeal residue and posterior oral spillage with penetration and aspiration in stroke.

Rarissa Rúbia Dallaqua Dos Santos,Roberta Gonçalves Da Silva,Adriana Gomes Jorge,Roberto Oliveira Dantas,Paula Cristina Cola,Fernanda Matias Peres,André Vinicius Marcondes Natel Sales,Priscila Watson Ribeiro

doi:10.1590/2317-1782/201420140476

Abstract

This study aimed at showing association between the posterior oral spillage and pharyngeal residue with tracheal aspiration and/or laryngeal penetration in stroke. Clinical cross-sectional retrospective multicenter study. The study included 63 videofluoroscopic tests of post-ischemic stroke individuals and oropharyngeal dysphagia data of the three reference centers providing care for patients with dysphagia (43 men and 20 women; age range: from 40 to 90 years). These individuals were divided into two groups. Group I consisted of 35 participants with the presence of penetration and/or laryngotracheal aspiration, and Group II consisted of 28 individuals with no penetration and/or aspiration. Videofluoroscopic swallowing test results were analyzed to divide the groups, and the presence of posterior oral spillage and pharyngeal residue was observed. No association was found between the groups with posterior oral spillage (χ²=1.65; p=0.30; φ²=0.02), but there was statistical difference for the association between pharyngeal residue (χ²=12.86; p=0.003; φ²=0.20) and the groups. There is an association between pharyngeal residue and penetration with tracheal aspiration in post-stroke individuals.

Highlights

The presence of oropharyngeal dysphagia in stroke has been analyzed since the 1970s, and the occurrence described in these studies ranges from 19 to 90%, being probably related to the presence of heterogeneous samples and different methods of investigation[1,2,3]
The identification of laryngeal penetration and laryngotracheal aspiration is a matter of constant concern for the screening and assessment instruments of oropharyngeal dysphagia, especially among post-stroke individuals[4,5,6]
Once the rehabilitation of these individuals confirms that we understand the reason for aspiration[7], only it will be possible to identify which aspects of the swallowing dynamics are causing these signals, and, we can properly plan the therapy for oropharyngeal dysphagia in cases of stroke

Summary

Introduction

The presence of oropharyngeal dysphagia in stroke has been analyzed since the 1970s, and the occurrence described in these studies ranges from 19 to 90%, being probably related to the presence of heterogeneous samples and different methods of investigation[1,2,3]. The identification of laryngeal penetration and laryngotracheal aspiration is a matter of constant concern for the screening and assessment instruments of oropharyngeal dysphagia, especially among post-stroke individuals[4,5,6]. Once the rehabilitation of these individuals confirms that we understand the reason for aspiration[7], only it will be possible to identify which aspects of the swallowing dynamics are causing these signals, and, we can properly plan the therapy for oropharyngeal dysphagia in cases of stroke. Most studies analyzing the frequency of these signals did not show associations or correlations between these and other changes in the swallowing dynamics[10,11,12,13]

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Conclusion