This study prospectively evaluated relationships between oral morbidities and swallowing ability in head/neck cancer patients following chemoradiation therapy (CRT) and at 3 months following CRT. Thirty patients with confirmed head/neck cancer undergoing chemoradiation were assessed with a battery of swallowing measures and measures of oral morbidities related to chemoradiation (xerostomia, mucositis, pain, taste/smell, oral moisture). All measures were completed at baseline (within the first week of CRT), at 6 weeks (end of treatment), and at 3 months following chemoradiation. Descriptive and univariate statistics were used to depict change over time in swallowing and each oral morbidity. Correlation analyses evaluated relationships between swallowing function and oral morbidities at each time point. Most measures demonstrated significant negative change at 6 weeks with incomplete recovery at 3 months. At 6 weeks, mucositis ratings, xerostomia, and retronasal smell intensity demonstrated significant inverse relationships with swallowing function. In addition, oral moisture levels demonstrated significant positive relationships with swallowing function. At 3 months, mucositis ratings maintained a significant, inverse relationship with swallow function. Taste and both orthonasal and retronasal smell intensity ratings demonstrated inverse relationships with measures of swallow function. Swallow functions and oral morbidities deteriorate significantly following CRT with incomplete recovery at 3 months post treatment. Furthermore, different patterns of relationships between swallow function measures and oral morbidities were obtained at the 6-week versus the 3-month assessment point suggesting that different mechanisms may contribute to the development versus the maintenance of dysphagia over the trajectory of treatment in these patients.

ObjectiveTo examine the effects of age, gender and bolus consistency in normal populations using the temporal measurement of Pharyngeal Transit Duration (PTD), which reflects the duration of bolus flow from the ramus of the mandible to the upper esophageal sphincter.Method40 normal and healthy subjects had Videofluoroscopic Swallowing Examinations (VFSEs) of 5 ml thin and nectar thick liquids, and puree consistencies. A slow motion and frame by frame analysis was performed. Three-way analysis of variance (ANOVA) was performed to examine the main effect and interactions, and paired t-tests for the three consistency comparisons.ResultsOlder subjects had a significantly longer PTD than younger subjects (p<0.01). In addition, men had significantly shorter PTDs than women (p<0.01). Puree showed a significantly longer PTD than the other two consistencies, regardless of age and gender (p<0.05).ConclusionPTD is an indicative of motor weakness in pharyngeal swallowing secondary to aging. In addition, the results supported the assumption that there is a functional difference in pharyngeal swallowing between men and women. It is expected that the results of this study will be used for further investigation of patients with dysphagia.

ObjectiveThe present study was performed to investigate the relationships between swallowing outcomes and lesion location, bolus characteristics, and age in patients with subcortical stroke.Patients: Patients with subcortical and insular stroke (mean age, 57.38 ± 12.71 years) were investigated. All patients (n = 21) completed both brain magnetic resonance imaging studies and videofluoroscopic swallowing studies.Main Outcome MeasuresThe oral transit duration, pharyngeal transit duration (PTD), laryngeal response duration, and Penetration-Aspiration Scale (PAS) score were applied to examine the efficiency of propulsion and airway protection in three swallowing tasks. Path analyses were performed to assess the relationships between swallowing outcomes and lesion location, age, bolus viscosity, and bolus volume.ResultsCaudate nucleus (CN) lesions were associated with higher PAS scores. Insular lesions were associated with a longer PTD. Advanced age was associated with a longer PTD. Bolus viscosity significantly moderated the association between CN lesions and higher PAS scores.ConclusionsIn the present cohort, CN lesions impacted airway protection and insular lesions impacted pharyngeal transit. An increased bolus viscosity reduced the aspiration severity. These results suggest that lesion location is an important indicator to predict subsequent dysphagia in patients with subcortical stroke.

Since swallowing function deteriorates with aging, it is crucial to examine the elderly's perception of their swallowing function and quality of life-swallowing. The purpose of this study was to establish the concurrent validity of the Swallowing Monitoring & Assessment Protocol (SMAP) and the Korean-Dysphagia Handicap Index (K-DHI). Methods: The results of the one-on-one survey via paper-pencil or mobile format presented to 91 older adults (men 20, women 71; mean age, 78 ± 6.47 years) among 579 participants recruited from the 16 senior welfare or senior community centers were analyzed. Individual responses were converted into scores and Pearson correlation and Spearman rank order statistical analyses were done via the IBM SPSS Statistics version 25. Results: There was a strong correlation (r= .825, p < .01) between the overall scores of the SMAP and the K-DHI. Analysis of rank ordered data of response frequency of the 13 items with similar contents in two evaluation tools also revealed a moderate correlation (r= .655, p < .05). Items related with 'dry mouth' ranked as the first complaint in both evaluation tools. Also, 'choking' and 'coughing' on liquids or water was ranked third (SMAP) and second (K-DHI) complaints, respectively, in both evaluation tools. Conclusion: It should be recognized that some swallowing problems observed in older adults may be a consequence of 'ageing' rather than features of 'disorder' , per se.