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Pharyngeal weakness and upper esophageal sphincter opening in patients with unilateral vocal fold immobility.
Laryngoscope. 2014 Oct; 124(10):2371-4.L

Abstract

OBJECTIVES/HYPOTHESIS

To evaluate pharyngeal strength and upper esophageal sphincter opening in patients with unilateral vocal fold immobility (UVFI).

STUDY DESIGN

Case control study.

METHODS

Charts of individuals with UVFI who underwent a videofluoroscopic swallow study were reviewed. To exclude confounding variables associated with pharyngeal weakness, inclusion was limited to patients with iatrogenic and idiopathic UVFI. Data abstracted included patient demographics, etiology of UVFI, pharyngeal constriction ratio (PCR), and upper esophageal sphincter (UES) opening (UESmax). Data were compared to age/gender-matched controls with no history of dysphagia or UVFI. Discrete variables were analyzed using a chi-square test of independence, and an independent samples t test was used to compare the UVFI and control groups (P = 0.05). A one-way analysis of variance (ANOVA) was used to compare iatrogenic and idiopathic UVFI groups.

RESULTS

The mean age of the cohort (n = 25) was 61 (±14 SD) years and 52% was female. The etiologies of UVFI were iatrogenic (n = 17) and idiopathic (n = 8). Thirty-eight percent of UVFI patients (n = 25) aspirated compared to 0% of controls (P < 0.05). The mean PCR for the UVFI group was 0.14 (±0.02) compared to 0.06 (±.01) for controls (P < 0.05). The mean UESmax for the UVFI group was 0.82 cm (±0.04) compared to 1.0 cm (±0.05) for controls (P > 0.05).

CONCLUSION

Individuals with UVFI of iatrogenic and idiopathic etiologies with subjective dysphagia demonstrate objective evidence of pharyngeal weakness. The increased prevalence of aspiration in this population may not be solely the result of impaired airway protection.

Authors+Show Affiliations

Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24925230

Citation

Domer, Amanda S., et al. "Pharyngeal Weakness and Upper Esophageal Sphincter Opening in Patients With Unilateral Vocal Fold Immobility." The Laryngoscope, vol. 124, no. 10, 2014, pp. 2371-4.
Domer AS, Leonard R, Belafsky PC. Pharyngeal weakness and upper esophageal sphincter opening in patients with unilateral vocal fold immobility. Laryngoscope. 2014;124(10):2371-4.
Domer, A. S., Leonard, R., & Belafsky, P. C. (2014). Pharyngeal weakness and upper esophageal sphincter opening in patients with unilateral vocal fold immobility. The Laryngoscope, 124(10), 2371-4. https://doi.org/10.1002/lary.24779
Domer AS, Leonard R, Belafsky PC. Pharyngeal Weakness and Upper Esophageal Sphincter Opening in Patients With Unilateral Vocal Fold Immobility. Laryngoscope. 2014;124(10):2371-4. PubMed PMID: 24925230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharyngeal weakness and upper esophageal sphincter opening in patients with unilateral vocal fold immobility. AU - Domer,Amanda S, AU - Leonard,Rebecca, AU - Belafsky,Peter C, Y1 - 2014/06/13/ PY - 2013/09/24/received PY - 2014/05/01/revised PY - 2014/05/20/accepted PY - 2014/6/14/entrez PY - 2014/6/14/pubmed PY - 2014/12/15/medline KW - Dysphagia KW - UVFI KW - iatrogenic vocal fold immobility KW - idiopathic vocal fold immobility KW - swallowing disorder KW - unilateral vocal fold immobility SP - 2371 EP - 4 JF - The Laryngoscope JO - Laryngoscope VL - 124 IS - 10 N2 - OBJECTIVES/HYPOTHESIS: To evaluate pharyngeal strength and upper esophageal sphincter opening in patients with unilateral vocal fold immobility (UVFI). STUDY DESIGN: Case control study. METHODS: Charts of individuals with UVFI who underwent a videofluoroscopic swallow study were reviewed. To exclude confounding variables associated with pharyngeal weakness, inclusion was limited to patients with iatrogenic and idiopathic UVFI. Data abstracted included patient demographics, etiology of UVFI, pharyngeal constriction ratio (PCR), and upper esophageal sphincter (UES) opening (UESmax). Data were compared to age/gender-matched controls with no history of dysphagia or UVFI. Discrete variables were analyzed using a chi-square test of independence, and an independent samples t test was used to compare the UVFI and control groups (P = 0.05). A one-way analysis of variance (ANOVA) was used to compare iatrogenic and idiopathic UVFI groups. RESULTS: The mean age of the cohort (n = 25) was 61 (±14 SD) years and 52% was female. The etiologies of UVFI were iatrogenic (n = 17) and idiopathic (n = 8). Thirty-eight percent of UVFI patients (n = 25) aspirated compared to 0% of controls (P < 0.05). The mean PCR for the UVFI group was 0.14 (±0.02) compared to 0.06 (±.01) for controls (P < 0.05). The mean UESmax for the UVFI group was 0.82 cm (±0.04) compared to 1.0 cm (±0.05) for controls (P > 0.05). CONCLUSION: Individuals with UVFI of iatrogenic and idiopathic etiologies with subjective dysphagia demonstrate objective evidence of pharyngeal weakness. The increased prevalence of aspiration in this population may not be solely the result of impaired airway protection. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/24925230/Pharyngeal_weakness_and_upper_esophageal_sphincter_opening_in_patients_with_unilateral_vocal_fold_immobility_ L2 - https://doi.org/10.1002/lary.24779 DB - PRIME DP - Unbound Medicine ER -