Respiratory-swallow phase patterns and their relationship to swallowing impairment in patients treated for oropharyngeal cancer

Background. Unstable respiratory–swallowing coordination has been associated with disorders and disease. The goals of this study were (1) to describe respiratory–swallow patterns in patients with dysphagia consequent to treatments for cancers of the oropharynx and (2) to determine the association be...

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Bibliographic Details
Published in:Head & neck 2010-04, Vol.32 (4), p.481-489
Main Authors: Brodsky, Martin B., McFarland, David H., Dozier, Thomas S., Blair, Julie, Ayers, Christopher, Michel, Yvonne, Gillespie, M. Boyd, Day, Terry A., Martin-Harris, Bonnie
Format: Article
Language:English
Subjects:
Adult
Aged
Barium Sulfate
Biological and medical sciences
chemotherapy
Chemotherapy, Adjuvant
Combined Modality Therapy
Cross-Sectional Studies
Deglutition - physiology
Deglutition Disorders - diagnosis
Deglutition Disorders - etiology
dysphagia
Esophagus
Female
Fluoroscopy - methods
Follow-Up Studies
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Male
Medical sciences
Middle Aged
Neoplasm Staging
oropharyngeal cancer
Oropharyngeal Neoplasms - complications
Oropharyngeal Neoplasms - pathology
Oropharyngeal Neoplasms - therapy
Oropharynx - drug effects
Oropharynx - radiation effects
Oropharynx - surgery
Other diseases. Semiology
Otorhinolaryngology. Stomatology
Postoperative Complications - diagnosis
Postoperative Complications - therapy
Probability
Prospective Studies
radiation
Radiotherapy, Adjuvant
Reference Values
respiration
Respiratory Aspiration - diagnosis
Respiratory Aspiration - etiology
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Background. Unstable respiratory–swallowing coordination has been associated with disorders and disease. The goals of this study were (1) to describe respiratory–swallow patterns in patients with dysphagia consequent to treatments for cancers of the oropharynx and (2) to determine the association between respiratory–swallow patterns, airway invasion, and overall severity of swallowing impairment. Methods. This prospective, cross‐sectional design compared respiratory–swallow patterns in 20 patients treated for oropharyngeal cancer and 20 healthy, age‐matched control participants. Nasal airflow direction was synchronously recorded with videofluoroscopic imaging in participants who swallowed 5‐mL thin liquid barium boluses. Results. Respiratory–swallow patterns differed between groups. Most control participants initiated and completed swallowing bracketed by expiratory airflow. Swallowing in patients often interrupted inspiratory flow and was associated with penetration or aspiration of the bolus. Conclusions. We suggest nonexpiratory bracketed respiratory–swallowing phase patterns in patients with oropharyngeal cancer may place patients at greater risk of airway penetration or aspiration during swallowing. © 2009 Wiley Periodicals, Inc. Head Neck, 2010
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.21209