Ann Rehabil Med.  2015 Aug;39(4):509-516. 10.5535/arm.2015.39.4.509.

The Effect of Stroke on Pharyngeal Laterality During Swallowing

Affiliations
  • 1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kyounghyochoi@gmail.com

Abstract


OBJECTIVE
To investigate whether patterns of dysphagia and swallowing laterality differ according to the location of brain lesions in patients with stroke.
METHODS
Patients with stroke >20 years of age were enrolled in this study. A videofluoroscopic swallowing study (VFSS) including the anterior-posterior view was used to assess swallowing. Patterns of swallowing were classified into three types according to the width of barium sulfate flow while passing the pharyngoesophageal segment: right-side-dominant flow, left-side-dominant flow, and no laterality in flow. Laterality was defined when the width of one side was twice or more the width of the other side.
RESULTS
A total of 92 patients who underwent swallowing function evaluations by VFSS were enrolled from Sep-tember 2012 to May 2013. Of these, 72 patients had supratentorial lesions (group I) and 20 patients had infratento-rial lesions (group II). Only 10 patients (13.9%) in group I and three patients (15.0%) in group II showed laterality. Of these 13 patients, laterality occurred on the left side regardless of the side of the brain lesion. No relationships were found between swallowing laterality and location of stroke or motor weakness.
CONCLUSION
The results suggest that swallowing laterality was not prevalent among patients with stroke and that lesion side, location of the brain lesion, or motor weakness did not influence swallowing laterality. Although stroke can cause symptoms of dysphagia, it is difficult to conclude that stroke has a crucial impact on swallowing laterality.

Keyword

Deglutition disorders; Deglutition; Stroke

MeSH Terms

Barium Sulfate
Brain
Deglutition Disorders
Deglutition*
Humans
Stroke*
Barium Sulfate

Reference

1. Meng NH, Wang TG, Lien IN. Dysphagia in patients with brainstem stroke: incidence and outcome. Am J Phys Med Rehabil. 2000; 79:170–175. PMID: 10744192.
2. Falsetti P, Acciai C, Palilla R, Bosi M, Carpinteri F, Zingarelli A, et al. Oropharyngeal dysphagia after stroke: incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit. J Stroke Cerebrovasc Dis. 2009; 18:329–335. PMID: 19717014.
Article
3. Bussell SA, Gonzalez-Fernndez M. Racial disparities in the development of dysphagia after stroke: further evidence from the Medicare database. Arch Phys Med Rehabil. 2011; 92:737–742. PMID: 21457943.
Article
4. Barer DH. The natural history and functional consequences of dysphagia after hemispheric stroke. J Neurol Neurosurg Psychiatry. 1989; 52:236–241. PMID: 2564884.
Article
5. Cola MG, Daniels SK, Corey DM, Lemen LC, Romero M, Foundas AL. Relevance of subcortical stroke in dysphagia. Stroke. 2010; 41:482–486. PMID: 20093638.
Article
6. Park DH, Chun MH, Lee SJ, Song YB. Comparison of swallowing functions between brain tumor and stroke patients. Ann Rehabil Med. 2013; 37:633–641. PMID: 24231855.
Article
7. Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005; 36:2756–2763. PMID: 16269630.
8. Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am. 2008; 19:853–866. ix-xPMID: 18940645.
Article
9. Langdon PC, Lee AH, Binns CW. Dysphagia in acute ischaemic stroke: severity, recovery and relationship to stroke subtype. J Clin Neurosci. 2007; 14:630–634. PMID: 17434310.
Article
10. Kim SY, Kim TU, Hyun JK, Lee SJ. Differences in videofluoroscopic swallowing study (VFSS) findings according to the vascular territory involved in stroke. Dysphagia. 2014; 29:444–449. PMID: 24682308.
Article
11. Kim HM, Choi KH, Kim TW. Patients' radiation dose during videofluoroscopic swallowing studies according to underlying characteristics. Dysphagia. 2013; 28:153–158. PMID: 22961462.
Article
12. Bhattacharyya N, Kotz T, Shapiro J. The effect of bolus consistency on dysphagia in unilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 2003; 129:632–636. PMID: 14663428.
Article
13. Seta H, Hashimoto K, Inada H, Sugimoto A, Abo M. Laterality of swallowing in healthy subjects by AP projection using videofluoroscopy. Dysphagia. 2006; 21:191–197. PMID: 16718623.
Article
14. Mosier KM, Liu WC, Maldjian JA, Shah R, Modi B. Lateralization of cortical function in swallowing: a functional MR imaging study. AJNR Am J Neuroradiol. 1999; 20:1520–1526. PMID: 10512240.
15. Kim MS, Lee SJ, Kim TU, Seo DH, Hyun JK, Kim JI. The influence of laterality of pharyngeal bolus passage on dysphagia in hemiplegic stroke patients. Ann Rehabil Med. 2012; 36:696–701. PMID: 23185735.
Article
16. Lee CK, Kim JA. Pattern of post-stroke swallowing disorder according to the brain lesion. J Korean Acad Rehabil Med. 2001; 25:193–201.
17. Kim J, Oh BM, Lee GJ, Lee SA, Chun SW, Han TR. Clinical factors associated with severity of post-stroke dysphagia. Brain Neurorehabil. 2011; 4:116–120.
Article
18. Han TR, Paik NJ, Park JW. The clinical functional scale for dysphagia in stroke patients. Korean J Stroke. 2001; 3:153–157.
19. Han TR, Paik NJ, Park JW. Quantifying swallowing function after stroke: a functional dysphagia scale based on videofluoroscopic studies. Arch Phys Med Rehabil. 2001; 82:677–682.
Article
20. Han TR, Paik NJ, Park JW. The functional dysphagia scale using videofluoroscopic swallowing study in stroke patients. J Korean Acad Rehabil Med. 1999; 23:1118–1126.
21. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996; 11:93–98.
Article
22. Lin CW, Chang YC, Chen WS, Chang K, Chang HY, Wang TG. Prolonged swallowing time in dysphagic Parkinsonism patients with aspiration pneumonia. Arch Phys Med Rehabil. 2012; 93:2080–2084. PMID: 22846454.
Article
23. Martin BJ, Corlew MM, Wood H, Olson D, Golopol LA, Wingo M, et al. The association of swallowing dysfunction and aspiration pneumonia. Dysphagia. 1994; 9:1–6. PMID: 8131418.
Article
24. Khedr EM, Abo-Elfetoh N, Ahmed MA, Kamel NF, Farook M, El Karn MF. Dysphagia and hemispheric stroke: a transcranial magnetic study. Neurophysiol Clin. 2008; 38:235–242. PMID: 18662620.
Article
25. Alberts MJ, Horner J, Gray L, Brazer SR. Aspiration after stroke: lesion analysis by brain MRI. Dysphagia. 1992; 7:170–173. PMID: 1499361.
Article
26. Broadley S, Croser D, Cottrell J, Creevy M, Teo E, Yiu D, et al. Predictors of prolonged dysphagia following acute stroke. J Clin Neurosci. 2003; 10:300–305. PMID: 12763332.
Article
27. Hamdy S, Aziz Q, Rothwell JC, Crone R, Hughes D, Tallis RC, et al. Explaining oropharyngeal dysphagia after unilateral hemispheric stroke. Lancet. 1997; 350:686–692. PMID: 9291902.
Article
28. Mosier KM, Liu WC, Maldjian JA, Shah R, Modi B. Lateralization of cortical function in swallowing: a functional MR imaging study. AJNR Am J Neuroradiol. 1999; 20:1520–1526. PMID: 10512240.
29. Teismann IK, Suntrup S, Warnecke T, Steinstrater O, Fischer M, Floel A, et al. Cortical swallowing processing in early subacute stroke. BMC Neurol. 2011; 11:34. PMID: 21392404.
Article
30. Hamdy S, Aziz Q, Rothwell JC, Power M, Singh KD, Nicholson DA, et al. Recovery of swallowing after dysphagic stroke relates to functional reorganization in the intact motor cortex. Gastroenterology. 1998; 115:1104–1112. PMID: 9797365.
Article
31. Hamdy S, Rothwell JC, Aziz Q, Singh KD, Thompson DG. Long-term reorganization of human motor cortex driven by short-term sensory stimulation. Nat Neurosci. 1998; 1:64–68. PMID: 10195111.
Article
32. Schmalfuss IM, Mancuso AA, Tart RP. Postcricoid region and cervical esophagus: normal appearance at CT and MR imaging. Radiology. 2000; 214:237–246. PMID: 10644131.
Article
Full Text Links
  • ARM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr