van der Bogt, R D; Vermeulen, B D; Reijm, A N; Siersema, P D; Spaander, M C W.

Best Pract Res Clin Gastroenterol; 36-37: 97-103, 2018 Oct – Dec. 

Imagem retirada da internet

RESUMO

Palliation of dysphagia is the cornerstone of palliative treatment in patients with incurable oesophageal cancer. Available palliative options for dysphagia are oesophageal stent placement and radiotherapy. In general, oesophageal stent placement is the preferred therapeutic option in patients with a relatively poor prognosis because of its rapid relief of dysphagia. Regardless of ongoing technical developments, recurrence of dysphagia and stent-related complications are still occurring. For patients with a relatively good prognosis, intra-luminal brachytherapy is advised because of its sustained palliation of dysphagia. Due to limited availability of intra-luminal brachytherapy in clinical practice, fractionated external beam radiation therapy is commonly applied as an alternative. Selection of the optimal palliative approach for patients remains however challenging as conclusive high-quality evidence is limited. Moreover, with the introduction of new palliative treatment options (e.g. palliative chemotherapeutic and radiotherapeutic options) and the concurrent change of patient characteristics, supporting evidence from large randomised studies is warranted.

ACESSE O PERIÓDICO

Felipe Moreti;

Bruna Morasco-Geraldini;

Simone Aparecida Claudino-Lopes;

Elisabete Carrara-de

Audiol., Commun. Res. vol.23  São Paulo  2018  Epub 18-Out-2018

http://dx.doi.org/10.1590/2317-6431-2017-1873 

LEIA O ARTIGO NA ÍNTEGRA

Bruno Francisco de Fraga; Sheila Tamanini de Almeida; Márcia Grassi Santana; Mauriceia Cassol

Int Arch Otorhinolaryngol 2018;22:225–230.

Fonte: Speechspark

ABSTRACT

Introduction Dysphagia causes changes in the laryngeal and stomatognathic struc- tures; however, the use of vocal exercises is poorly described.

Objective To verify whether the therapy consisting of myofunctional exercises associated with vocal exercises is more effective in rehabilitating deglutition in stroke patients.

Methods This is a pilot study made up of two distinct groups: a control group, which performed only myofunctional exercises, and an experimental group, which performed myofunctional and vocal exercises. The assessment used for oral intake was the functional oral intake scale (FOIS).

Results The FOIS levels reveal that the pre-therapy median of the experimental group was 4, and increased to 7 after therapy, while in the control group the values were 5 and 6 respectively. Thus, the experimental group had a statistically significant difference between the pre- and post-therapy assessments (p 1⁄4 0.039), which indicates that the combination of myofunctional and vocal exercises was more effective in improving the oral intake levels than the myofunctional exercises alone (p 1⁄4 0.059). On the other hand, the control group also improved, albeit at a lower rate compared with the experimental group; hence, there was no statistically significant difference between the groups post-therapy (p 1⁄4 0.126).

Conclusion This pilot study showed indications that using vocal exercises in swallow- ing rehabilitation in stroke patients was able to yield a greater increase in the oral intake levels. Nevertheless, further controlled blind clinical trials with larger samples are required to confirm such evidence, as this study points to the feasibility of conducting this type of research.

LEIA O ARTIGO NA ÍNTEGRA

Howell, R.J., Webster, H., Kissela, E. et al.

Dysphagia (2019)

https://doi.org/10.1007/s00455-019-09982-z

ACESSE O PERIÓDICO

Ohkubo, M. & Scobbie, J.M.

Dysphagia (2019) 34: 112.

https://doi.org/10.1007/s00455-018-9921-8

                                                                                                                              Fonte: Researchgate

Abstract

Ultrasound imaging is simple, repeatable, gives real-time feedback, and its dynamic soft tissue imaging may make it superior to other modalities for swallowing research. We tested this hypothesis and measured certain spatial and dynamic aspects of the swallowing to investigate its efficacy. Eleven healthy adults wearing a headset to stabilize the probe participated in the study. Both thickened and thin liquids were used, and liquid bolus volumes of 10 and 25 ml were administered to the subjects by using a cup. The tongue’s surface was traced as a spline superimposed on a fan-shaped measurement space for every image from the time at which the tongue blade started moving up toward the palate at the start of swallowing to the time when the entire tongue was in contact with the palate. To measure depression depth, the distance (in mm) was measured along each radial fan line from the location at which the tongue’s surface spline intersected the fan line to the point where the hard palate intersected the fan line at each timepoint. There were differences between individual participants in the imageability of the swallow, and so we defined quantitatively “measureable” and “unmeasurable” types. The most common type was measureable, in which we could find a clear bolus depression in the cupped tongue’s surface. Indeed, with 10 ml of thin liquids, we were able to find and measure the depression depth for all participants. The average maximum radial distance from the palate to the tongue’s surface was 20.9 mm (median) (IQR: 4.3 mm) for swallowing 10 ml of thin liquid compared to 24.6 mm (IQR: 3.3 mm) for 25 ml of thin liquid swallow (p < 0.001). We conclude that it is possible to use ultrasound imaging of the tongue to capture spatial aspects of swallowing.