• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.3
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• pp.280-287
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• 2014

The aim of this study was to collect and analyze clinical studies on electro-acupuncture therapies of post-stroke dysphagia to suggest the methods of the study about electro-acupuncture therapy. In this study, electronic searches were performed with searching sites. Searched words such as '중풍', '뇌졸중', '연하장애', '전침', 'stroke', 'dysphagia', 'deglutition disorders', 'electro-acupuncture' were used as a single keyword or in combinations. Through searching, 27 studies were selected and analyzed. In comparison of results before and after electro-acupuncture treatment, there were statistically significant improvement in 26 studies by using assessment such as video fluoroscopy swallowing study, swallowing water function test. The study of electro-acupuncture treatment for post-stroke dysphagia needs to be standardized and high-quality study models should be introduced.

• Journal of Yeungnam Medical Science
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• v.40 no.1
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• pp.91-95
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• 2023

Psychogenic dysphagia is a deglutition disorder characterized by a fear of swallowing, with no structural or functional causes. This report presents the case of a young male patient who had severe malnutrition due to psychogenic dysphagia and was provided visual biofeedback using fiberoptic endoscopic evaluation of swallowing (FEES). A healthy 25-year-old man presented to our clinic with a complaint of throat discomfort when swallowing that had started 6 months prior. As the symptoms worsened, he became fearful of food spreading to his lungs after swallowing and the development of respiratory difficulties. His food intake gradually decreased, resulting in a weight loss of 20 kg within 2 months. Evaluation of organic and other functional causes of dysphagia was performed, but no abnormalities were detected. The sensation of a lump in his throat, fear of swallowing, and anxiety were transformed into somatic symptoms. The patient was diagnosed with psychogenic dysphagia. After visual biofeedback by a physician who performed FEES, the patient resumed eating normally and increased his food intake. If routine tests do not reveal structural or functional causes of dysphagia, assessment of a psychogenic swallowing disorder should be considered. FEES can help in the diagnosis and management of psychogenic dysphagia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.11-13
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• 2016

Dysphagia incidence can be up to 90% of patients after CVA disease and most of the patients demonstrate speech problems as well as dysphagia. The term of swallowing includes the entire process of deglutition from the placement of food in the mouth until the food enters to the esophagus through the oral and pharyngeal cavities. Swallowing functions share common anatomic structures and characteristics of physiology with speech in many aspects. Therefore, speech-language pathologists can help people with swallowing disorders. Herein the approaches and rationales for improving speech and swallowing functions in patients with stroke need to be discussed depending on the lesion sites of the brain.

• Speech Sciences
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• v.9 no.4
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• pp.3-14
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• 2002

VPI occurs when the velum and lateral and posterior pharyngeal wall fail to separate the nasal cavity from the oral cavity during deglutition and speech. There are a number of congenital and acquired conditions which result in VPI. Congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency (CPI). Acquired conditions include carcinoma of the palate or pharynx and neurologic disorders. The speech characteristics of VPI is characterized by hypernasality, nasal air emission, decreased intraoral air pressure, increased nasal air flow, decreased intelligibility. VPI can be treated with various methods that include speech therapy, surgical procedures to reduce the velopharyngeal gap, speech aid prosthesis, and combination of surgery and prosthesis. This article describes four cases of VPI treated by speech aid prosthesis and speech therapy with satisfactory result.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.524-527
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• 2021

Herein, we describe the case of a 20-year-old woman who presented with dysphagia of 2 months' duration associated with vomiting, moderate abdominal pain, decreased oral intake, and significant weight loss. During the past 3 years, the patient experienced intermittent mild abdominal pain with infrequent vomiting. Endoscopy at Jordan University Hospital showed a mass in the esophagus, and endoscopic biopsies were performed. The preliminary histopathological report excluded malignancy. Two days after endoscopy, the patient presented to the emergency department complaining of severely worsening pain and total dysphagia. The pain persisted despite intravenous paracetamol administration, which was concerning for esophageal perforation; therefore, an urgent surgical intervention was performed. The mass was removed surgically, along with a para-esophageal lymph node. The final histopathological results of the endoscopic and resected specimens supported the diagnosis of pseudomyogenic hemangioendothelioma (PMHE). This is the first case reporting esophageal involvement of PMHE.

• Therapeutic Science for Rehabilitation
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• v.11 no.1
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• pp.21-33
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• 2022

Purpose : The purpose of this study was to establish scientific evidence though a systematic review, of the existing interventional methods and their respective effects, for swallowing disorders among dementia patients. The interventional methods were based on patient characteristics. Methods : An electronic literature search was performed using five electronic databases from 2010 to 2020. The keywords were 'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'. Five articles met the inclusion criteria. Results : One study with moderate-to-severe and four studies with severe dementia patients were included. The interventions consisted of one remedial intervention, three compensatory interventions, and one comprehensive intervention. Compensatory intervention, including behavioral and psychological management, were used in moderate-to-severe patients. For the severe patients, remedial, compensatory, and comprehensive intervention were used to address the feeding tube problem. The interventions used in each study had a positive effect on the outcome variables associated with swallowing ability. Conclusion : The purpose of the intervention and the intervention factors changed depending on the patient's dementia stage. The intervention was effective when considering the progressive stage of the patient. These results may serve as a guide in designing effective interventions for swallowing disorders in dementia patients.

• Journal of Korean Academy of Nursing
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• v.45 no.1
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• pp.1-13
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• 2015

Purpose: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes. Methods: A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses. Results: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents. Conclusion: Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

• Korean Journal of Adult Nursing
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• v.25 no.2
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• pp.113-124
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• 2013

Purpose: Purposes of this study were to develop a reliable and valid checklist to assess and manage post-stroke dysphagia and to identify its utilization. Methods: The first step was to develop checklist through systematic literatures reviews, to test the content validity from 11 clinical experts, and to test the construct validity and the internal consistency from 97 patients with post-stroke dysphagia. The second step was to identify clinical use of the checklist from the same 97 patients. Results: A total of 18 items compromised the assessment checklist and 64 items for intervention checklist. Internal consistencies of assessment checklist and intervention checklist were .84 and .98, respectively. In both checklists, level of utilization of general appearance was the highest, while that of early signs of aspiration was the lowest. The utilization levels of two checklists were significantly higher among patients who were less than 60 years old, and had liquid diet, facial paralysis, and previous history of aspiration pneumonia. Conclusion: We found that the checklists were reliable and valid. Further study is needed to develop specific strategies to improve nurses' use of assessment and intervention checklists for post-stroke dysphagia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.36-44
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• 2019

Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.2
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• pp.685-693
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• 2012

The purpose of this study was to develop a dysphagia assessment tool and a intervention program for elderly in the long-term care facilities and to evaluate its effect. The dysphagia assessment tool consists of 20 items was developed through literature review, previous studies and discussion with nursing/medical members. The intervention program consisted of 72 items and participants for evaluation were 50 elders who were registered at long-term care facilities in 4 regions of Seoul. Collected data were analyzed using SPSS Statistics 18.0 and Spearman's Correlation, t-test, and $x^2$-test. After the application of the dysphagia assessment tool and intervention program, the weight in experimental group was increased (t=4.913, p=.000) and the total time of swallowing was reduced (t=-4.557, p=.000) than control group. These findings were statistically significant. Considering these results, by applying the dysphagia assessment tool and the intervention program, the lives of the elderly in long-term care facilities are expected to be improved and emergency situations such as aspiration pneumonia and asphyxia will be decreased.