Cranial Nerve IX and X Impairment After a Sports-related Jefferson (C1) Fracture in a 16-Year-Old Male

Dettling, Samuel; Morscher, Melanie A.; Masin, Jeffrey S.; Adamczyk, Mark J.

doi:10.1097/bpo.0b013e3182746bc1

Cited by 19 publications

(21 citation statements)

References 13 publications

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“…Videofluoroscopic swallowing studies were the most commonly used instrumental assessment, however FEES was used in conjunction with VFSS in two studies [11, 13]. Synthesis of the results from the 5 studies revealed a common pattern of swallowing difficulties for individuals with spinal cord injury; these results are summarized in Table 4.…”

Section: Discussionmentioning

confidence: 99%

“…As these complications can impair swallowing function, and lead to secondary restrictions of pharyngeal movement or epiglottic deflection, the use of steroid treatment or antibiotics post-operatively has potential to improve swallowing outcomes [23, 24]. In the studies reviewed, steroids and antibiotics appeared to contribute to improved swallowing function when used in addition to other swallowing interventions, primarily tube feedings [12, 13]. …”

Section: Discussionmentioning

confidence: 99%

“…Dettling, Morscher, Masin, and Adamczyk [13] reported the case of a 16 year old male who sustained a C1 burst facture with bilateral anterior ring fractures and a posterior fracture on the right side of the C1 ring during a tackle while playing football. Following surgery for halo fixation, the patient complained of dysphagia.…”

Section: Summary Of Articles Included In Qualitative Reviewmentioning

confidence: 99%

“…Within this article set, dysphagia was often diagnosed based on the incidence of aspiration before, during, or following the swallow [13, 14]. Although aspiration can occur when an individual has dysphagia, it is not the only characteristic of a swallowing impairment.…”

Section: Limitationsmentioning

confidence: 99%

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A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

2016

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Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Summary Of Articles Included In Qualitative Reviewmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

2016

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“…Injury to the four lower cranial nerves IX, X, XI and XII, eponymously named Collet‐Sicard Syndrome, is reported in 14 cases of blunt cranial trauma . Other reported cases of unilateral vagus nerve paralysis secondary to trauma involve combinations of two or more of the lower cranial nerves . Axial loading is the most common mechanism of injury and in all except one case a fracture of the occipital condyle or C1 vertebra is described.…”

mentioning

confidence: 99%

Isolated unilateral vocal fold palsy: a rare complication of base of skull trauma

Trautman

Sarofim

Kwok

et al. 2019

ANZ Journal of Surgery

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Voluntary Cough Testing as a Clinical Indicator of Airway Protection in Cervical Spinal Cord Injury

et al. 2022

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Objective Voluntary cough testing (VCT) may be useful for determining aspiration risk in neurogenic dysphagia; however, has yet to be investigated in traumatic cervical spinal cord injury (tCSCI). The study explored if VCT may elucidate swallowing safety and kinematics related to airway protection in tCSCI survivors. Methods Ten inpatients, 13–73 days post‐tCSCI (7 incomplete injuries), completed VCT and a modified barium swallowing study that was analyzed via the Penetration Aspiration Scale (PAS) and norm‐referenced measures of swallowing events related to airway protection. Spearman rho correlations explored relations among cough airflow, median PAS, and airway protection. Mann–Whitney U tests explored group differences based on clinical airway invasion (PAS > 2) and receiver operating characteristic statistics probed the sensitivity/specificity of VCT measures. Results Safe (PAS > 2) and unsafe swallowers differed by cough volume acceleration (CVA) for the total sample and by inspiratory duration for incomplete injuries (p = 0.03, r > 0.7). A cut‐off value of 24.8 L/s for CVA predicted airway invasion (AUC = 0.917, p = 0.03) with sensitivity = 100%/specificity = 75%. CVA correlated with delayed laryngeal vestibule closure during swallowing for both the total sample and for incomplete injuries (rs > 0.6, p < 0.05). Blunted peak flow and prolonged cough phases were associated with disordered laryngeal kinematics and prolonged bolus transit during swallowing (p < 0.05). Conclusions Reduced CVA, blunted peak flow, and prolonged cough phases reflected PAS and disrupted mechanisms of airway protection in tCSCI survivors, demonstrating promise for VCT as a clinical assessment for post‐tCSCI dysphagia. Level of Evidence 3 Laryngoscope, 133:1434–1441, 2023

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Cranial Nerve IX and X Impairment After a Sports-related Jefferson (C1) Fracture in a 16-Year-Old Male

Abstract: Level V, case report.

Cited by 19 publications

References 13 publications

A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

A Review of Dysphagia Presentation and Intervention Following Traumatic Spinal Injury: An Understudied Population

Isolated unilateral vocal fold palsy: a rare complication of base of skull trauma

Voluntary Cough Testing as a Clinical Indicator of Airway Protection in Cervical Spinal Cord Injury

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