Correlação entre funcionalidade bulbar e penetração e/ou aspiração laringotraqueal na doença do neurônio motor

Brandão, Bárbara Carolina; Galdino, Alline de Sousa; Lourenção, Luciano Garcia; Trindade, Glaucia Santana; Silva, Magali Aparecida Orate Menezes da; Silva, Roberta Gonçalves da

doi:10.1590/2317-1782/20182017056

Cited by 2 publications

(3 citation statements)

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“…Specifically, individuals with bulbar-onset disease demonstrated slower rate of decline on the motor subscore and hastened decline on the bulbar subscore compared to those with spinal onset disease [ 14 ]. One study of 18 individuals with motor neuron disease (MND) investigated the relationship between the ALSFRS-R bulbar subscore and radiographically confirmed airway invasion; however, individuals who aspirated during swallowing were not included in the study cohort, limiting the generalization of the results [ 15 ]. The discriminant ability of the bulbar subscore and swallowing item score to detect radiographically confirmed pharyngeal dysphagia in ALS has not yet been determined.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of the amyotrophic lateral sclerosis Functional Rating Scale—Revised to detect pharyngeal dysphagia in individuals with amyotrophic lateral sclerosis

et al. 2020

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The ALS Functional Rating Scale-Revised (ALSFRS-R) is the most commonly utilized instrument to index bulbar function in both clinical and research settings. We therefore aimed to evaluate the diagnostic utility of the ALSFRS-R bulbar subscale and swallowing item to detect radiographically confirmed impairments in swallowing safety (penetration or aspiration) and global pharyngeal swallowing function in individuals with ALS. Methods Two-hundred and one individuals with ALS completed the ALSFRS-R and the gold standard videofluoroscopic swallowing exam (VFSE). Validated outcomes including the Penetration-Aspiration Scale (PAS) and Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) were assessed in duplicate by independent and blinded raters. Receiver operator characteristic curve analyses were performed to assess accuracy of the ALSFRS-R bulbar subscale and swallowing item to detect radiographically confirmed unsafe swallowing (PAS > 3) and global pharyngeal dysphagia (DIGEST >1). Results Although below acceptable screening tool criterion, a score of � 3 on the ALSFRS-R swallowing item optimized classification accuracy to detect global pharyngeal dysphagia (

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Section: Introductionmentioning

confidence: 99%

Diagnostic utility of the amyotrophic lateral sclerosis Functional Rating Scale—Revised to detect pharyngeal dysphagia in individuals with amyotrophic lateral sclerosis

et al. 2020

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“…Oropharyngeal aspiration (abbreviated to aspiration) results from oropharyngeal dysphagia, impaired swallow‐respiratory coordination, reduced laryngeal sensation (eg reduced cough reflex), abnormal anatomical structure/s of the aerodigestive tract (eg tracheoesophageal fistula) and/or muscle weakness in the oropharynx (eg reduced pharyngeal contraction, reduced tongue‐palate pressure) . In some circles, this type of aspiration is also known as laryngotracheal aspiration …”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6] In some circles, this type of aspiration is also known as laryngotracheal aspiration. 7 Accurate diagnosis of aspiration is important to prevent aspiration-related acute (eg apnoea, pneumonia) and chronic (eg bronchiectasis) respiratory sequelae 8 in infants and children. Worldwide, speech pathologists lead in the multidisciplinary assessment of aspiration.…”

Section: Introductionmentioning

confidence: 99%

Clinical feeding examination with cervical auscultation for detecting oropharyngeal aspiration: A systematic review of the evidence

Frakking

Chang

David³

et al. 2019

Clinical Otolaryngology

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Background Cervical auscultation (i.e. listening to swallowing sounds) is the most commonly used technique in adjuvant to the clinical feeding examination by speech‐language pathologists worldwide to assess for oropharyngeal aspiration risk in children. Despite its relative popularity in clinical practice, little is known on the clinical utility of cervical auscultation within a paediatric population. Objective To determine the diagnostic test accuracy of the clinical feeding examination with cervical auscultation in the detection of aspiration in children. Type of review Narrative review. Prospero Registration: CRD42017081467 Search strategy: Medline/Pub Med, Embase, CINAHL, AustHealth, Cochrane and UQ (Scopus) were searched up until October 2017. Specifically, the search terms used were: (((oropharyngeal OR respiratory) aspiration) AND (child* OR pediatr* OR paediatr*) and (cervical auscultation OR swallow sounds OR swallowing sounds OR accelerometry OR swallowing acoustics)). The search strategy also included scanning reference lists and citations of retrieved studies. Evaluation method Extracted studies were reviewed by two independent reviewers. Methodological quality of studies was assessed using the QUADAS‐2 tool. Results Only one study met inclusion criteria for this review, which had a bias for flow and timing. Use of cervical auscultation in conjunction with the clinical feeding examination to predict aspiration had a positive predictor value (PPV) of only 0.49 (0.31‐0.66), indicating potential over‐prediction of aspiration when cervical auscultation is used. In contrast a high NPV of 0.92 (0.78‐0.98) was reported indicating that cervical auscultation is useful at ruling out aspiration in children. Conclusion This review highlights the paucity of research studies assessing the accuracy of cervical auscultation as an adjuvant to the clinical feeding examination in aspiration detection within the paediatric population.

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Correlação entre funcionalidade bulbar e penetração e/ou aspiração laringotraqueal na doença do neurônio motor

Abstract: Negative correlation was observed between bulbar functionality and laryngeal penetration in MND. The bulbar parameters of the ALSFRS-R/BR are significant for predicting risk of laryngotracheal aspiration for pasty consistency in MND.

Cited by 2 publications

References 16 publications

Diagnostic utility of the amyotrophic lateral sclerosis Functional Rating Scale—Revised to detect pharyngeal dysphagia in individuals with amyotrophic lateral sclerosis

Diagnostic utility of the amyotrophic lateral sclerosis Functional Rating Scale—Revised to detect pharyngeal dysphagia in individuals with amyotrophic lateral sclerosis

Clinical feeding examination with cervical auscultation for detecting oropharyngeal aspiration: A systematic review of the evidence

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