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Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience
Authors:Katherine A. Kendall  Julia Ellerston  Amanda Heller  Daniel R. Houtz  Chong Zhang  Angela P. Presson
Affiliation:1.Voice Disorders Center,University of Utah,Salt Lake City,USA;2.Communication Sciences & Disorders,University of Utah,Salt Lake City,USA;3.Study Design and Biostatistics Center,University of Utah,Salt Lake City,USA;4.Division of Otolaryngology, Head & Neck Surgery,University of Utah,Salt Lake City,USA;5.Division of Epidemiology, Department of Internal Medicine,University of Utah,Salt Lake City,USA
Abstract:Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.
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