• The Journal of the Korean dental association
• /
• v.56 no.5
• /
• pp.287-295
• /
• 2018

Eating-swallowing disorder (dysphagia) is a very important functional problem for the elderly, and it has a significant impact on the quality of their life. Because the eating and swallowing processes are affected by oral tissues including teeth, tongue, and oral muscles, it is natural that the dentist as a specialist in oro-facial region, intervenes in the diagnosis and treatment of the disorder. Nevertheless, Korean dentists still lack interest and understanding of dysphagia. In aged society, it is necessary that the dentists understand the functional disorders as well as oral diseases. The purpose of this study is to introduce the evaluation and treatment methods of eating and swallowing functional disorders in order to cope with eating-swallowing disordered patients who are frequently encountered in aged society.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• v.60 no.9
• /
• pp.454-462
• /
• 2017

Background and Objectives The present study aimed to investigate the effects of penetration/aspiration (P/A) on voice acoustic parameters. Subjects and Method Twenty-seven patients were analyzed with the videofluoroscopic swallowing study (VFSS) and then divided into two groups based on the modified Penetration and Aspiration Scale results. Ten patients (5 males and 5 females) were included in the Non-P/A group, and 17 patients (12 males and 5 females) in the P/A group. Stroke was the major cause of swallowing disorders. Three sustained /a/ vowels recorded in pre- and post-VFSS were analyzed. Mann-Whitney U-test was used to compare acoustic values before and after VFSS, and the receiver operating characteristics (ROC) curve with combination of significant parameters was also conducted. Results Among acoustic parameters, the length of analyzed sample (p=0.010), number of segments computed (p=0.018), total number detected pitch periods (p=0.017), and second formant (p=0.013) in pre- and post-VFSS were significantly different between Non-P/A and P/A groups. In the P/A group after VFSS, the means of these significant parameters decreased. According to ROC combined with four significant parameters, the probability of predicting P/A condition was 84% (p=0.005), the sensitivity was 80%, and the specificity was 80%. Conclusion Voice acoustic analysis can reflect voice changes by penetration/aspiration and the combination of significant parameters can also detect swallowing disorders. Therefore, voice analysis can be a reliable screening tool for patients with swallowing disorders.

• The Journal of the Korean dental association
• /
• v.53 no.11
• /
• pp.789-794
• /
• 2015

Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals' knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.

• Phonetics and Speech Sciences
• /
• v.5 no.4
• /
• pp.43-51
• /
• 2013

The purpose of this study is to survey Speech-Language Pathologists' perception on evaluation and treatment of "swallowing disorders". An online questionnaire was sent to the 279 subjects attending undergraduate/graduate programs in speech therapy department and/or SLPs who work in various settings. The survey consisted of three parts: 1) background information and educational/clinical experiences that are associated with dysphagia (swallowing disorder), 2) the current state of diagnosis and treatment of dysphagia of clinical practice (certified SLPs only), 3) the recognition of diagnosis, treatment, education for dysphagia. Each item of the survey was scaled by the participants on a five-point Likert scale of 1 to 5 (1 being not at all and 5 being extremely) or self-reported answers. The results of the survey showed that SLPs have high interest in "swallowing disorder", but most of them regarded them very difficult to diagnose and treat. The reason is that they have not been trained as a swallowing specialist. Therefore it is necessary to provide more opportunities for education and practice to establish the expertise of SLPs.

• The Journal of Internal Korean Medicine
• /
• v.43 no.3
• /
• pp.469-476
• /
• 2022

Objectives: This study aimed to report on a systemic sclerosis patient diagnosed with Yulgyuk and Banui syndrome improved by Korean medical treatment. Methods: We treated a 70-year-old woman who had swallowing disorders and frequent vomiting caused by systemic sclerosis with herbal medicine and acupuncture treatment for six months. Treatment was evaluated with a numerical rating scale (NRS). Results: After treatment, swallowing disorders and frequent vomiting decreased. The NRS decreased from 8 to 3. Conclusions: This case suggests that Korean medical treatment was effective for alleviating a swallowing disorder and frequent vomiting caused by systemic sclerosis as a conservative treatment.

• Journal of Oral Medicine and Pain
• /
• v.25 no.2
• /
• pp.191-203
• /
• 2000

This study was performed to investigate the relationship between vertical dimension during swallowing and speech pattern in patients with temporomandibular disorders. For this study, 33 patients with temporomandibular disorders(TMDs), namely, 17 patients with disc displacement with reduction and 16 patients with disc displacement without reduction, and 30 normal subjects without any signs and symptoms in the masticatory system were selected as the patient group and as the normal group, respectively. Biopak $system^{(R)}$(Bioresearch Inc., Milwaukee, USA) was used for recording of electromyographic(EMG) activity(${\mu}V$) of the anterior temporalis, the superficial masseter, the sternocleidomastoideus and the trapezius insertion muscle during swallowing, and of mandibular positional change with function time(sec.) during swallowing and speech. A sentence of 'Sue is missing her house' was used for observing of speech pattern. Comparison between the two groups and relationship of the mandibular positional change and the function time between during swallowing and during speech were analysed by SPSS windows program. The results of this study were as follows : 1. Mean EMG activity of the trapezius insertion during swallowing was higher in the patient group, and the value was $3.4{\mu}V$ in patients and $2.1{\mu}V$ in normal subjects. 2. Vertica1 dimension(VD) at mandibular rest position before swallowing was slightly higher in the patient group, but VD at swallowing-late stage and at rest position after swallowing were not different between the two groups. 3. Swallowing time were 2.1 sec. in the patient group, and 1.5 sec. in the normal group, and the difference was significant. 4. VD during speech were generally higher in the normal group. In this case, speaking position showing the most difference between the two groups was 'her' position. The distance from habitual intercuspal position to 'her' position was 4.9mm in the patient group, and 6.6mm in the normal group. Speaking time was also longer in the patient group. 5. There were no difference in all observed items between the two categories of the patient group according to reduction of disc displacement. 6. Relationship between the positional changes during swallowing and speech were different between the patient group and the normal group. And in the normal group, VD at rest position before swallowing was negatively correlated with speaking time.

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

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.1
• /
• pp.7-12
• /
• 2022

Tracheostomy refers to a surgical incision created in the neck to allow direct air entry into the trachea bypassing the upper respiratory tract including the oral and nasal cavities. Normal vocalization and swallowing are limited immediately postoperatively; however, gradual recovery of vocalization and swallowing function can be initiated, following improvement in the causative condition that necessitated the tracheostomy. Duration of the tracheostomy depends upon the patient's condition, and the degree of vocalization and swallowing function recovery after tracheostomy tube removal varies widely across patients. In this review, we investigated the changes associated with vocalization and swallowing function in patients who underwent tracheostomy and have discussed the various approaches and voice rehabilitation treatments to aid with normal recovery.

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

• Phonetics and Speech Sciences
• /
• v.10 no.4
• /
• pp.147-154
• /
• 2018

Wet voice quality (WVQ) is a characteristic that appears after swallowing. Although the concept is accepted by many clinicians worldwide, it is nevertheless ambiguous. In this study, we investigated WVQ in patients with swallowing disorders using acoustic analysis. A total of 106 patients diagnosed with penetration-aspiration by the videofluoroscopic swallowing study (VFSS) were recruited. A voice recording of vowel /a/ was conducted before and after the VFSS, and an acoustic analysis was then performed using PRAAT. Voice after VFSS was used for a perceptual judgment and divided into two groups: the Wet group (48 patients) and the Non-wet group (58 patients). At the post-VFSS stage, the two groups displayed significant differences in many acoustic parameters including F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP. The parameter affecting judging wetness resulted into Jitter and NHR by the logistic regression test. At the pre-VFSS stage, the two groups differed significantly in many acoustic parameters including Intensity, Jitter, RAP, Shimmer, NHR, FUF, DVB, and CPP. Both pre-and post-VFSS, the mean values of all significant parameters, except Intensity, HNR, and CPP, were higher in the Wet group. According to pre-and post-VFSS, the two groups displayed interactions in many parameters (Intensity, F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP). In particular, Intensity increased in both groups after the VFSS, although the increase in the Non-wet group was greater. Based on these results, it was conjectured that the WVQ after swallowing resulted from the secretion effect of the mucous membrane due to the dry laryngeal characteristic of elderly patients, rather than aspiration resulting in food on the vocal cords.