Comparison of Swallowing Functions Between Brain Tumor and Stroke Patients

Abstract

ObjectiveTo compare the swallowing functions according to the lesion locations between brain tumor and stroke patients.MethodsForty brain tumor patients and the same number of age-, lesion-, and functional status-matching stroke patients were enrolled in this study. Before beginning the swallowing therapy, swallowing function was evaluated in all subjects by videofluoroscopic swallowing study. Brain lesions were classified as either supratentorial or in-fratentorial. We evaluated the following: the American Speech-Language-Hearing Association (ASHA) National Outcome Measurement System (NOMS) swallowing scale, clinical dysphagia scale, functional dysphagia scale (FDS), penetration-aspiration scale (PAS), oral transit time, pharyngeal transit time, the presence of vallecular pouch residue, pyriform sinus residue, laryngopharyngeal incoordination, premature spillage, a decreased swal-lowing reflex, pneumonia, and the feeding method at discharge.ResultsThe incidence of dysphagia was similar in brain tumor and stroke patients. There were no differences in the results of the various swallowing scales and other parameters between the two groups. When compared brain tumor patients with supratentorial lesions, brain tumor patients with infratentorial lesions showed higher propor-tion of dysphagia (p=0.01), residue (p<0.01), FDS (p<0.01), PAS (p<0.01), and lower ASHA NOMS (p=0.02) at initial evaluation. However, there was no significant difference for the swallowing functions between benign and malig-nant brain tumor patients.ConclusionSwallowing function of brain tumor patients was not different from that of stroke patients according to matching age, location of lesion, and functional status. Similar to the stroke patients, brain tumor patients with infratentorial lesions present poor swallowing functions. However, the type of brain tumor as malignancy does not influence swallowing functions.

The Effect of Stroke on Pharyngeal Laterality During Swallowing

“…Fourth, there was a relatively smaller sample size in the second group when compared with the first group. Post-stroke dysphagic patterns show differences according to location of the brain lesion, whether it was a supratentorial or infratentorial lesion [ 6 16 ], unlike our study which showed no differences between supratentorial or infratentorial lesions. This may have been due to the discrepancy in the sample size between the two groups.…”

“…Dysphagia is a disorder of deglutition that affects oral, pharyngeal, and esophageal phases of swallowing [ 5 ]. Interruption of voluntary control of mastication, bolus transport, and impairment of facial, lip, or tongue motor control are caused by cerebral, cerebellar, or brain stem strokes [ 6 ] and can result in impairment of swallowing physiology [ 7 ]. Dysphagia should be treated, as it can lead to health-related complications, such as pneumonia as well as nutrition and hydration deficits [ 7 8 9 10 ].…”

Rehabilitation of Adult Patients with Primary Brain Tumors: A Narrative Review

“…Incidence of these events can be decreased through rehabilitation specific to swallowing, as functional dysphagia improvements have been reported [13]. Patients with infratentorial tumors have dysphagia at higher frequencies than those with supratentorial lesions and no difference in frequency was noted between malignant and benign tumors [34].…”

Pneumonia in palliative care patients, part 1 – principles of diagnosis and treatment, hospital-acquired pneumonia, and community-acquired pneumonia

“…Do czynników ryzyka zachłystowego zapalenia płuc należą wszystkie stany prowadzące do zaburzeń świadomości -w sposób odwrotnie proporcjonalny do punktacji uzyskanej przez chorego w skali Glasgow [18] -w tym stosowanie farmakologicznej sedacji [4], szczególnie w połączeniu z długotrwałym przebywaniem w pozycji leżącej na plecach [19]. Zachłystowe zapalenie płuc występuje częściej u pacjentów po udarze lub urazie mózgu [4,14], u chorych na nowotwory regionu głowy i szyi [20][21][22], u pacjentów z wewnątrzczaszkowym efektem masy [23]. Kolejnymi czynnikami ryzyka są: zniesiony odruch kaszlu [4,21], obecność masy patologicznej w drogach oddechowych [21] oraz przewlekłe choroby płuc upośledzające oczyszczanie dróg oddechowych [4,14], takie jak POChP.…”