Ann Rehabil Med.  2012 Oct;36(5):696-701.

The Influence of Laterality of Pharyngeal Bolus Passage on Dysphagia in Hemiplegic Stroke Patients

• Kim MS
• Lee SJ
• Kim TU
• Seo DH
• Hyun JK
• Kim JI

Abstract

OBJECTIVE
To investigate swallowing laterality in hemiplegic patients with stroke and recovery of dysphagia according to the laterality. METHOD: The sample was comprised of 46 dysphagic patients with hemiplegia after their first stroke. The sample's videofluoroscopic swallowing study (VFSS) was reviewed. Swallowing laterality was determined by the anterior-posterior view of VFSS. We measured width difference of barium sulfate liquid flow in the pharyngoesophageal segment. If there was double or more the width of that from the opposite width in the pharyngoesophageal segment more than twice on three trials of swallowing, then it was judged as having laterality. Subjects were assigned to no laterality (NL), laterality that is ipsilateral to hemiplegic side (LI), and laterality that is contralateral to hemiplegic side (LC) groups. We measured the following: prevalence of aspiration, the 8-point penetration-aspiration scale, and the functional dysphagia scale of the subjects at baseline and follow up.
RESULTS
Laterality was observed in 45.7% of all patients. Among them, 52.4% were in the hemiplegic direction. There was no significant difference between groups at baseline in all measurements. When we compared the changes in all measurements on follow-up study, there were no significant differences between groups.
CONCLUSION
Through this study, we found that there was no significant relation between swallowing laterality and the severity or prognosis of swallowing difficulty. More studies for swallowing laterality on stroke patients will be needed.

Keyword

Swallowing; Laterality; Dysphagia; Stroke

MeSH Terms

Barium Sulfate
Deglutition
Deglutition Disorders
Follow-Up Studies
Hemiplegia
Humans
Prevalence
Prognosis
Stroke
Barium Sulfate

Reference

1. 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.

2. Logemann JA, Kahrilas PJ, Kobara M, Vanki NB. The benefit of head rotation on pharyngoesophageal dysphagia. Arch Phys Med Rehabil. 1989; 70:767–771. PMID: 2802957.

3. Mikushi S, Saitoh E, Tohara H, Baba M, Uematsu H. Laterality of pharyngeal bolus passage in Wallenberg's syndrome patients with dysphagia. J Med Dent Sci. 2007; 54:147–157.

4. 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.

5. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A Penetration-aspiration scale. Dysphagia. 1996; 11:93–98. PMID: 8721066.

6. 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.