The role of the prosthodontist regarding aspirative dysphagia

Gary, John J.; Johnson, Andrew C.; Garner, Fred T.

doi:10.1016/0022-3913(92)90058-i

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…The OPM is a valuable tool for evaluating airway protective mechanics, especially in neurologically impaired patients. 12 We currently utilize it to determine those at increased risk for CPA. 24 However, its exact role in the diagnosis of CPA remains to be demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…Associated disorders, variable clinical presentations, and lack of specific diagnostic criteria make CPA difficult to confirm or rule out. 8 Diagnostic tests used to evaluate patients for CPA include imaging studies (chest X-ray, 9 upper gastrointes-tinal series [UGI], [9][10][11] modified barium swallow [also known as oropharyngeal motility study, or OPM], 12,13 gastroesophageal scintigraphy [GES], 14,15 ) and 24-h pH probe studies. 16 While positive studies are highly suggestive of chronic aspiration, false positives occur, and none of these tests can rule out the diagnosis of aspiration.…”

Section: Introductionmentioning

confidence: 99%

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Chronic aspiration in children: Evaluation of the lipid-laden macrophage index

Bauer

Lyrene

1999

Pediatr. Pulmonol.

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Chronic pulmonary aspiration (CPA) causes significant morbidity, but is underdiagnosed because of difficulties in establishing a diagnosis. The lipid‐laden macrophage index (LLMI) is said to differentiate between those with and without CPA. Records of 113 patients were reviewed to determine specificity and sensitivity of the LLMI for CPA. Diagnostic accuracy was inferred from treatment outcome. Mean LLMI for aspirators was 104 ± 62 (range, 20–233), and for nonaspirators, 44 ± 39 (range, 0–170) (P < 0.05). Sensitivity and specificity were 0.69 and 0.79, respectively. While the LLMI provides clinically helpful information, it does not stand alone as the gold standard for the diagnosis of CPA. Failure to thrive and neurological impairment correlated with CPA, using Fisher's exact test. CPA was not diagnosed in any patient with normal growth, normal neurological development, and an LLMI <86. No other clinical observation (cough, wheeze, vomiting, difficulty feeding, choking with feeding, recurrent pneumonia, bronchopulmonary dysplasia, chronic chest X‐ray changes, endotracheal tube, tracheostomy tube, nasogastric feeding tube, or transpyloric feeding tube) or diagnostic study (upper gastrointestinal series, gastroesophageal scintigraphy, modified barium swallow, or pH probe) correlated with the diagnosis of CPA. Pediatr Pulmonol. 1999; 28:94–100. © 1999 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%