CoDAS
http://www.codas.periodikos.com.br/article/doi/10.1590/2317-1782/20192018160
CoDAS
Artigo original

Pharyngeal residue in neurogenic oropharyngeal dysphagia

Resíduos faríngeos nas disfagias orofaríngeas neurogênicas

Giovana Aparecida Dias de Souza; Roberta Gonçalves da Silva; Paula Cristina Cola; Suely Mayumi Motonaga Onofri.

Downloads: 3
Views: 986

Abstract

Purpose: To compare pharyngeal residues of different consistencies among groups of individuals with neurogenic oropharyngeal dysphagia. Methods: In a cross-sectional study, a fiberoptic endoscopic evaluation was performed in 30 swallowing exams of individuals diagnosed with neurological disease and oropharyngeal dysphagia, regardless of the time or stage of the disease. The individuals were divided into three groups according to etiology: group I, 10 post-stroke, 8 male and 2 female, aged 51 to 80 years (average age: 67 years); group II, 10 individuals with amyotrophic lateral sclerosis, 5 male and 5 female, aged 39 to 78 years (average age: 57 years); group III, 10 examinations of individuals with Parkinson’s disease, 5 male and 5 female aged 65-88 years (average age: 74 years). The Yale Pharyngeal Residue Severity Rating Scale was applied by two independent raters in a blind manner for the analysis of pharyngeal residues in valleculae and pyriform sinuses based on the first swallowing of 5 mL of pureed and thickened liquid. Results: No statistically significant difference was observed among groups in the degree of pharyngeal residues of puree food or thickened liquid in the valleculae (p = 0.25/p = 0.18) or the pyriform sinuses (p = 1.41/0.49). Conclusion: The pharyngeal residue levels of pureed and thickened liquid were similar for the groups studied, with less severe levels being more frequent.

Keywords

Swallowing Disorders; Endoscopy; Stroke; Amyotrophic Lateral Sclerosis; Parkinson’s Disease.

Resumo

Objetivo: Comparar os resíduos faríngeos por consistência de alimento entre indivíduos com disfagia orofaríngea neurogênica. Método: Estudo clínico transversal. Realizada análise de 30 exames de videoendoscopia de deglutição de indivíduos com diagnóstico de doenças neurológicas e disfagia orofaríngea, independentemente do tempo ou estágio das doenças. Os indivíduos foram divididos em três grupos: o grupo I composto por 10 indivíduos pós-Acidente Vascular Cerebral, 8 homens e 2 mulheres, faixa etária entre 51 e 80 anos (média 67 anos); o grupo II por 10 indivíduos com Esclerose Lateral Amiotrófica, 5 homens e 5 mulheres, faixa etária entre 39 e 78 anos (média 57 anos), e o grupo III por 10 indivíduos com Doença de Parkinson (DP), 5 homens e 5 mulheres, faixa etária entre 65 e 88 anos (média 74 anos). Para análise dos resíduos faríngeos em valéculas e seios piriformes, foi aplicada a Yale Pharyngeal Residue Severity Rating Scale, considerando a primeira deglutição de 5 mL nas consistências pastosa e líquida espessada, por dois juízes independentes e de forma cega. Resultados: Não houve diferença estatística significativa nos resíduos faríngeos, em valéculas (p= 0,25/ p= 0,18) e seios piriformes (p= 1,41/ 0,49), respectivamente nas consistências pastosa e líquida espessada, nas diferentes doenças estudadas. Conclusão: Os níveis de resíduos faríngeos na consistência pastosa ou líquida espessada na população estudada foram semelhantes e mais frequentes nos níveis menos grave.

Palavras-chave

Transtornos da Deglutição; Endoscopia; Acidente Vascular Cerebral; Esclerose Lateral Amiotrófica; Doença de Parkinson.

Referências

1 Miller KM, Willging JP. Advances in the evaluation and management of pediatric dysphagia. Curr Opin Otolaryngol Head Neck Surg. 2003;11(6):442-6. http://dx.doi.org/10.1097/00020840-200312000-00006. PMid:14631176. [ Links ]

2 Takizawa C, Gemmell E, Kenworthy J, Speyer R. A systematic review of the prevalence of Oropharyngeal dysphagia in Stroke, Parkinson’s Disease, Alzheimer’s Disease, Head Injury, and Pneumonia. Dysphagia. 2016;31(3):434-41. http://dx.doi.org/10.1007/s00455-016-9695-9. PMid:26970760. [ Links ]

3 Clavé P, Kraa TM, Serra M. Approaching oropharyngeal dysphagia. Rev Esp Enferm Dig. 2004;96(2):119-31. [ Links ]

4 Wirth R, Dziewas R. Neurogene dysphagie. Internist. 2017;58(2):132-40. http://dx.doi.org/10.1007/s00108-016-0178-8. PMid:28084502. [ Links ]

5 Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia. 1988;2(4):216-9. http://dx.doi.org/10.1007/BF02414429. PMid:3251697. [ Links ]

6 Aviv JE, Martin JH, Keen MS, Debell M, Blitzer A. Air pulse quantification of supraglottic and pharyngeal sensation: A new technique. Ann Otol Rhinol Laryngol. 1993;102(10):777-80. http://dx.doi.org/10.1177/000348949310201007. PMid:8215097. [ Links ]

7 Bastian RW. Videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallow. Otolaryngol Head Neck Surg. 1991;104(3):339-50. http://dx.doi.org/10.1177/019459989110400309. PMid:1902935. [ Links ]

8 Butler SG, Stuart A, Markley L, Rees C. Penetration and aspiration in healthy older adults as assessed during endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol. 2009;118(3):190-8. http://dx.doi.org/10.1177/000348940911800306. PMid:19374150. [ Links ]

9 Baijens LWJ, Pilz W, Kremer B, Passos VL. Identifying patterns of FEES-Derived swallowing trajectories using group-based trajectory model. Dysphagia. 2015;30(5):529-39. http://dx.doi.org/10.1007/s00455-015-9632-3. PMid:26209286. [ Links ]

10 Eckley CA, Fernandes, AM. Método de avaliação otorrinolaringológica da deglutição. Acta ORL/Técnicas em Otorrinolaringologia, 2005; 23(4):12-16. [ Links ]

11 Onofri SM, Cola PC, Berti LC, da Silva RG, Dantas RO. Correlation between laryngeal sensitivity and penetration/aspiration after stroke. Dysphagia. 2014;29(2):256-26. http://dx.doi.org/10.1007/s00455-013-9504-7. PMid:24442645. [ Links ]

12 Kelly AM, Leslie P, Beale T, Payten C, Drinnan MJ. Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin Otolaryngol. 2006;31(5):425-32. http://dx.doi.org/10.1111/j.1749-4486.2006.01292.x. PMid:17014453. [ Links ]

13 Murray J, Langmore SE, Ginsberg S, Dostie A. The significance of accumulated oropharyngeal secretions and swallowing frequency in precicting aspiration. Dysphagia. 1996;11(2):99-103. http://dx.doi.org/10.1007/BF00417898. PMid:8721067. [ Links ]

14 Pisegna JM, Langmore SE. Parameters of instrumental swallowing evaluations: describinga diagnostic dilemma. Dysphagia. 2016;31(3):462-72. http://dx.doi.org/10.1007/s00455-016-9700-3. PMid:26987971. [ Links ]

15 Neubauer PD, Rademaker AW, Leder SB. The Yale Pharyngeal Residue severity rating scale: na anatomically defined and image-based tool. Dysphagia. 2015;30(5):521-8. http://dx.doi.org/10.1007/s00455-015-9631-4. PMid:26050238. [ Links ]

16 Neubauer PD, Hersey DP, Leder SB. Pharyngeal Residue Severity rating scales based on fiberoptic endoscopic evaluation of swallowing: a systematic review. Dysphagia. 2016;31(3):352-9. http://dx.doi.org/10.1007/s00455-015-9682-6. PMid:26753927. [ Links ]

17 Paixão CT, Silva LD, Camerini FG. Perfil da disfagia após um acidente vascular cerebral: uma revisão integrativa. Rev. Rene. Fortaleza. 2010;11(1):181-90. [ Links ]

18 Santos RRD, Sales AVMN, Cola PC, Ribeiro PW, Jorge AG, Peres FM, et al. Associação entre presença de resíduos faríngeos e escape oral posterior e a ocorrência de penetração e aspiração no Acidente Vascular Encefálico. CoDAS. 2014;26(3):231-4. http://dx.doi.org/10.1590/2317-1782/201420140476. PMid:25118920. [ Links ]

19 Bigal A, Harumi D, Luz M, Luccia G, Bilton T. Disfagia do idoso: estudo videofluoroscópico de idosos com e sem doença de Parkinson. Distúrb Comun. 2007;19(2):213-23. [ Links ]

20 Argolo N, Sampaio M, Pinho P, Melo A, Nobrega AC. Videofluoroscopic predictors of penetration-aspiration in Parkinson’s Disease Patients. Dysphagia. 2015;30(6):751-8. http://dx.doi.org/10.1007/s00455-015-9653-y. PMid:26492880. [ Links ]

21 Pflug C, Bihler M, Emich K, Niessen A, Nienstedt JC, Flugel T, et al. Critical dysphagia is common in Parkinson Disease and occurs even in early stages: a prospective cohort study. Dysphagia. 2018;33(1):41-50. http://dx.doi.org/10.1007/s00455-017-9831-1. PMid:28828545. [ Links ]

22 Ottaviano FG, Filho TAL, Andrade HMT, Alves PCL, Rocha MSG. Vídeoendoscopia da deglutição na esclerose lateral amiotrófica. Rev Bras Otorrinolaringol. 2013;79(3):349-53. [ Links ]

23 Pontes RT, Orsini M, Freitas MRG, Antonioli RS, Nascimento OJM. Alterações da fonação e deglutição na Esclerose Lateral Amiotrófica: revisão de Literatura. Rev Neurocienc. 2010;18(1):69-73. [ Links ]

24 Fattori B, Siciliano G, Mancini V, Bastiani L, Bongioanni P, Caldarazzo Ienco E, et al. Dysphagia in Amyotrophic Lateral Sclerosis: Relationships between disease progression and Fiberoptic Endoscopic Evaluation of Swallowing. Auris Nasus Larynx. 2017;44(3):306-12. http://dx.doi.org/10.1016/j.anl.2016.07.002. PMid:27569290. [ Links ]

25 Molfenter SM, Steele CM. The relationship between residue and aspiration on the subsequent swallow: An application of the normalized residue ratio scale. Dysphagia. 2013;28(4):494-500. http://dx.doi.org/10.1007/s00455-013-9459-8. PMid:23460344. [ Links ]

26 Eisenhuber E, Schima W, Schober E, Pokieser P, Stadler A, Scharitzer M, et al. Videofluoroscopic assessment of patients with Dysphagia: Pharyngeal retention is a predictive factor for aspiration. AJR. 2002;178(2):393-8. http://dx.doi.org/10.2214/ajr.178.2.1780393. PMid:11804901. [ Links ]

27 Oliveira DL, Moreira EAM, Freitas MB, Gonçalves JA, Furkim AM, Clavé P. Pharyngeal residue and aspirations and the relationship with clinical/nutritional status of the patients with Oropharyngeal Dysphagia submitted to videofluoroscopy. J Nutr Health Aging. 2016;21(3):336-41. PMid:28244575. [ Links ]

28 Clavé P, de Kraa M, Arreola V, Girvent M, Farré R, Palomera E, et al. The effect of bolus viscosity on swallowing function in neurogenic dysphagia. Aliment Pharmacol Ther. 2006;24(9):1385-94. http://dx.doi.org/10.1111/j.1365-2036.2006.03118.x. PMid:17059520. [ Links ]


Submetido em:
20/07/2018

Aceito em:
20/02/2019

5dc9e1970e88259c47bc9c52 codas Articles

CoDAS

Share this page
Page Sections