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The management of swallowing disorders through rehabilitation methods

Year 2005, Volume: 14 Issue: 1, 10 - 17, 20.02.2005

Abstract

Objectives: Swallowing disorders are commonly encountered in ENT practice, and dysphagia may pre- sent a challenge with respect to diagnosis and man­ agement. This study aimed to examine patients with swallowing disorders.Patients and Methods: The study included 280 patients 153 males, 127 females; mean age 53 years; range 3- 98 years who presented with complaints of swallowing difficulties betvveen October 2000 and June 2002. The patients were examined according to the protocol of our department for swallowing disorders, which involved a detailed history taking, a patient questionnaire on swal- lovving disorders, cervical auscultation, and modified bar- ium swallow studies. When further investigation was needed, fiber-optic endoscopic swallow studies, ultra- sonic evaluation of the tongue base, neck CT, and 24- hour double-probe pH monitoring were also undertaken.Results: A diagnosis of a swallowing disorder prema­ türe spills, pulling in the vallecula and/or pyriform sinuses, penetration and/or aspiration, and delayed swallow reflex was made in 164 patients. Dysphagia arose from a mechanical cause in 55%, and from a neurological cause in 32%. A multiphase rehabilitation program was initiated, which included positioning, adjusting bolus con- sistency, oral-motor range of motion exercises, use of palatal devices and swallowing techniques. Rehabilitation resulted in normal swallowing in 128 patients 78% .Conclusion: Mechanical causes should also be sought in patients with swallowing disorders.

References

  • Logemann JA. Factors affecting ability to resume oral nutrition in the oropharyngeal dysphagic individual. Dysphagia. 1990;4:202-8.
  • Logeman J. Evaluation and treatment of swallowing disorders. San Diego, College Hill Press 1983;11-36.
  • Strand EA, Miller RM, Yorkston KM, Hillel AD. Management of oral-pharyngeal dysphagia symptoms in amyotrophic lateral sclerosis. Dysphagia 1996;11:129-39.
  • Breen K. Dysphagia: dysphagia and other esophageal problems. Modern Medicine 2001;18:47-52.
  • Logeman J. Therapy for orophayngeal swallowing dis- orders. In: Perlman AL, Schultze-Delrieu K, editors. Deglutition and its disorders. 2nd ed. San Diego: Singular Publishing; 1997. p. 449-63.
  • Groher ME, Dysphagia: Diagnosis and management, 2nd ed. Boston: Butterworth-Heinemann 1992.
  • Schulze-Delrieu K, Miller RM. Clinical assessment of dysphagia. In: Perlman AL, Schultze-Delrieu K, edi- tors. Deglutition and its disorders. 2nd ed. San Diego: Singular Publishing; 1997. p. 125-53.
  • Yorkston KM, Miller RM, Strand EA. Amyotrophic lat- eral sclerosis. In: Management of speech and swallow- ing in degenerative diseases. 1st ed. Tucson: Communication Skill Builders; 1995. p. 3-86.
  • Langmore SE, Schatz K, Olson N. Endoscopic and videofluoroscopic evaluations of swallowing and aspi- ration. Ann Otol Rhinol Laryngol 1991;100:678-81.
  • Kidder TM, Langmore SE, Martin BJ. Indications and techniques of endoscopy in evaluation of cervical dys- phagia: comparison with radiographic techniques. Dysphagia. 1994;9:256-61.
  • Dodds WJ, Logemann JA, Stewart ET. Radiologic assessment of abnormal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol. 1990;154:965-74.
  • Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modi- fied barium swallow. Dysphagia 2000;15:136-41.
  • Teasell RW, Finston HM, Greene-Finestone L. Dysphagia and nutrition following stroke. Phys Med Rehabil 1993;7:89.
  • DePippo KL, Holas MA, Reding MJ, Mandel FS, Lesser ML. Dysphagia therapy following stroke: a controlled trial. Neurology 1994;44:1655-60.
  • Cherney LR, Halper AS. Swallowing problems in adults with traumatic brain injury. Semin Neurol 1996;16:349-53.

Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları

Year 2005, Volume: 14 Issue: 1, 10 - 17, 20.02.2005

Abstract

Amaç: Yutma bozuklukları kulak burun boğaz pratiğinde sık karşılaşılan bir durumdur ve disfaji, tanı vetedavisinde güçlüklerle karşılaşılan bir semptomdur.Bu çalışmada yutma bozukluğu olan hastalar değerlendirmeye alındı. Hastalar ve Yöntemler: Kliniğimize Ekim 2000-Haziran 2002 tarihleri arasında yutma sorunları nedeniyleyutma polikliniğine başvuran 280 hasta 153 erkek, 127kadın; ort. yaş 53; dağılım 3-98 yaş incelendi. Hastaların ayrıntılı öyküsü alındı; yutma değerlendirme anketformu ile yakınmaları değerlendirildi; kliniğimizin tanıprotokolüne göre servikal oskültasyon, modifiye baryumlu yutma çalışmaları uygulandı; gerektiğinde fiberoptik endoskopik yutma, dil kökü ultrasonografisi, boyun tomografisi veya reflü açısından çift problu özofajeal pH metre çalışması da tanıya yardımcı yöntemlerolarak eklendi.Bulgular: Değerlendirme sonrasında 164 hasta yutmabozukluğu tanısı ile göllenme, prematür kaçak, penetrasyon/aspirasyon ve gecikmeli yutma yutma rehabilitasyonu programına alındı. Disfajinin hastaların%55’inde mekanik kökenli, %32’sinde nörolojik kökenliolduğu belirlendi. Rehabilitasyon çok aşamalı olarakpozisyonlama, kıvam ayarlama, oral-motor açıklık vekuvvetlendirme egzersizleri, yutma apereleri ve yutmateknikleri olarak uygulandı. Tedavi sonrasında 128hasta %78 normal yemek yemeye başladı.Sonuç: Yutma bozukluğu olan hastalarda mekaniknedenlerin de incelenmesi gerektiği kanısına varıldı

References

  • Logemann JA. Factors affecting ability to resume oral nutrition in the oropharyngeal dysphagic individual. Dysphagia. 1990;4:202-8.
  • Logeman J. Evaluation and treatment of swallowing disorders. San Diego, College Hill Press 1983;11-36.
  • Strand EA, Miller RM, Yorkston KM, Hillel AD. Management of oral-pharyngeal dysphagia symptoms in amyotrophic lateral sclerosis. Dysphagia 1996;11:129-39.
  • Breen K. Dysphagia: dysphagia and other esophageal problems. Modern Medicine 2001;18:47-52.
  • Logeman J. Therapy for orophayngeal swallowing dis- orders. In: Perlman AL, Schultze-Delrieu K, editors. Deglutition and its disorders. 2nd ed. San Diego: Singular Publishing; 1997. p. 449-63.
  • Groher ME, Dysphagia: Diagnosis and management, 2nd ed. Boston: Butterworth-Heinemann 1992.
  • Schulze-Delrieu K, Miller RM. Clinical assessment of dysphagia. In: Perlman AL, Schultze-Delrieu K, edi- tors. Deglutition and its disorders. 2nd ed. San Diego: Singular Publishing; 1997. p. 125-53.
  • Yorkston KM, Miller RM, Strand EA. Amyotrophic lat- eral sclerosis. In: Management of speech and swallow- ing in degenerative diseases. 1st ed. Tucson: Communication Skill Builders; 1995. p. 3-86.
  • Langmore SE, Schatz K, Olson N. Endoscopic and videofluoroscopic evaluations of swallowing and aspi- ration. Ann Otol Rhinol Laryngol 1991;100:678-81.
  • Kidder TM, Langmore SE, Martin BJ. Indications and techniques of endoscopy in evaluation of cervical dys- phagia: comparison with radiographic techniques. Dysphagia. 1994;9:256-61.
  • Dodds WJ, Logemann JA, Stewart ET. Radiologic assessment of abnormal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol. 1990;154:965-74.
  • Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modi- fied barium swallow. Dysphagia 2000;15:136-41.
  • Teasell RW, Finston HM, Greene-Finestone L. Dysphagia and nutrition following stroke. Phys Med Rehabil 1993;7:89.
  • DePippo KL, Holas MA, Reding MJ, Mandel FS, Lesser ML. Dysphagia therapy following stroke: a controlled trial. Neurology 1994;44:1655-60.
  • Cherney LR, Halper AS. Swallowing problems in adults with traumatic brain injury. Semin Neurol 1996;16:349-53.
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Mustafa Gerek This is me

Müzeyyen Çiyiltepe This is me

Publication Date February 20, 2005
Published in Issue Year 2005 Volume: 14 Issue: 1

Cite

APA Gerek, M., & Çiyiltepe, M. (2005). Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları. The Turkish Journal of Ear Nose and Throat, 14(1), 10-17.
AMA Gerek M, Çiyiltepe M. Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları. Tr-ENT. February 2005;14(1):10-17.
Chicago Gerek, Mustafa, and Müzeyyen Çiyiltepe. “Yutma bozukluğu Olan Hastalarda Rehabilitasyon yöntemleri Ve sonuçları”. The Turkish Journal of Ear Nose and Throat 14, no. 1 (February 2005): 10-17.
EndNote Gerek M, Çiyiltepe M (February 1, 2005) Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları. The Turkish Journal of Ear Nose and Throat 14 1 10–17.
IEEE M. Gerek and M. Çiyiltepe, “Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları”, Tr-ENT, vol. 14, no. 1, pp. 10–17, 2005.
ISNAD Gerek, Mustafa - Çiyiltepe, Müzeyyen. “Yutma bozukluğu Olan Hastalarda Rehabilitasyon yöntemleri Ve sonuçları”. The Turkish Journal of Ear Nose and Throat 14/1 (February 2005), 10-17.
JAMA Gerek M, Çiyiltepe M. Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları. Tr-ENT. 2005;14:10–17.
MLA Gerek, Mustafa and Müzeyyen Çiyiltepe. “Yutma bozukluğu Olan Hastalarda Rehabilitasyon yöntemleri Ve sonuçları”. The Turkish Journal of Ear Nose and Throat, vol. 14, no. 1, 2005, pp. 10-17.
Vancouver Gerek M, Çiyiltepe M. Yutma bozukluğu olan hastalarda rehabilitasyon yöntemleri ve sonuçları. Tr-ENT. 2005;14(1):10-7.