Deglutition after near-fatal choking episode: radiologic evaluation.

Feinberg, Michael J.; Ekberg, Olle

doi:10.1148/radiology.176.3.2389020

Cited by 27 publications

(10 citation statements)

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“…Entry of food or liquid into the laryngeal area has been associated with AC surgery and may cause acute airway obstruction and death. 23,24 No cases of aspiration pneumonia were observed in patients enrolled in this study, perhaps in part because of the rigorous evaluation and preventative treatment instituted.…”

Section: Discussionmentioning

confidence: 94%

Prospective Analysis of Incidence and Risk Factors of Dysphagia in Spine Surgery Patients

Smith-Hammond

New²,

Pietrobon³

et al. 2004

Spine

268

169

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Section: Discussionmentioning

confidence: 94%

Prospective Analysis of Incidence and Risk Factors of Dysphagia in Spine Surgery Patients

Smith-Hammond

New²,

Pietrobon³

et al. 2004

Spine

268

169

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“…Patients with retention of chewed solid foods may be at risk for aspirating these boluses with resultant airway obstruction [13]. It may not be possible to identify these individuals unless a highly viscous material (such as our ultrathick liquid) is tested.…”

Section: Discussionmentioning

confidence: 99%

Effect of Liquid Bolus Consistency and Delivery Method on Aspiration and Pharyngeal Retention in Dysphagia Patients

2001

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There is no empirically derived consensus as to what food consistency types and method of food delivery (spoon, cup, straw) should be included in the videofluoroscopic swallowing (VFSS) studies. In the present study, we examine the rates of aspiration and pharyngeal retention in 190 dysphagic patients given thin (apple juice) and thick (apricot nectar) liquids delivered by teaspoon and cup and ultrathick (pudding-like) liquid delivered by teaspoon. Each patient was tested with each of the bolus/delivery method combinations. The fractions of patients exhibiting aspiration for each bolus/method of delivery combination were (1) thick liquids (cup), 13.2%; (2) thick liquids (spoon), 8.9%; (3) thin liquids (cup), 23.7%; (4) thin liquids (spoon), 15.8%, (5) ultrathick liquids (spoon), 5.8%. In each comparison [thick liquid (cup) vs. thick liquid (spoon), thin liquid (cup) vs. thin liquid (spoon), thick liquid (cup) vs. thin liquid (cup), thick liquid (spoon) vs. thin liquid (spoon), and thick liquid (spoon) vs. ultrathick liquid (spoon)], the p value for chi 2 was < 0.001. These results suggest that utilizing thin, thick, and ultrathick liquids and delivery by cup and spoon during a VFSS of a patient with mild or moderate dysphagia can increase the chances of identifying a consistency that the patient can swallow without aspirating and without pharyngeal retention after swallowing.

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“…These new findings suggest that normal humans are at risk for inadvertently inhaling food particles both before and after swallowing. Indeed, obstruction of the airway by inhaled food is a significant cause of morbidity and mortality in otherwise healthy individuals [36]. Swallowing never occurs in isolation.…”

Section: Aspiration Risk and The Intranarial Larynxmentioning

confidence: 99%

Coordination of mastication and swallowing

et al. 1992

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The coordination of mastication, oral transport, and swallowing was examined during intake of solids and liquids in four normal subjects. Videofluorography (VFG) and electromyography (EMG) were recorded simultaneously while subjects consumed barium-impregnated foods. Intramuscular electrodes were inserted in the masseter, suprahyoid, and infrahyoid muscles. Ninety-four swallows were analyzed frame-by-frame for timing of bolus transport, swallowing, and phases of the masticatory gape cycle. Barium entered the pharynx a mean of 1.1 s (range -0.3 to 6.4 s) before swallow onset. This interval varied significantly among foods and was shortest for liquids. A bolus of food reached the valleculae prior to swallow onset in 37% of sequences, but most of the food was in the oral cavity at the onset of swallowing. Nearly all swallows started during the intercuspal (minimum gape) phase of the masticatory cycle. Selected sequences were analyzed further by computer, using an analog-to-digital convertor (for EMG) and frame grabber (for VFG). When subjects chewed solid food, there were loosley linked cycles of jaw and hyoid motion. A preswallow bolus of chewed food was transported from the oral cavity to the oropharynx by protraction (movement forward and upward) of the tongue and hyoid bone. The tongue compressed the food against the palate and squeezed a portion into the pharynx one or more cycles prior to swallowing. This protraction was produced by contraction of the geniohyoid and anterior digastric muscles, and occurred during the intercuspal (minimum gape) and opening phases of the masticatory cycle. The mechanism of preswallow transport was highly similar to the oral phase of swallowing. Alternation of jaw adductor and abductor activity during mastication provided a framework for integration of chewing, transport, and swallowing.

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Deglutition after near-fatal choking episode: radiologic evaluation.

Cited by 27 publications

References 0 publications

Prospective Analysis of Incidence and Risk Factors of Dysphagia in Spine Surgery Patients

Prospective Analysis of Incidence and Risk Factors of Dysphagia in Spine Surgery Patients

Effect of Liquid Bolus Consistency and Delivery Method on Aspiration and Pharyngeal Retention in Dysphagia Patients

Coordination of mastication and swallowing

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