Relationship between post-stroke dysphagia and pharyngeal sensory impairment

Neurological Research and Practice

Research Article

Tobias Warnecke¹  Rainer Dziewas¹  Stephan Oelenberg²  Sonja Suntrup-Krueger²  Jonas von Itter²  Fiona Wenninger²  Sigrid Ahring²  Inga Claus²  Anne Jung²  Malte Roderigo²  Bendix Labeit³  Paul Muhle³ 

[1] Department of Neurology and Neurorehabilitation, Klinikum Osnabrueck – Academic teaching hospital of the WWU, Muenster, Germany;Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1; Building A1, 48149, Muenster, Germany;Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1; Building A1, 48149, Muenster, Germany;Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany;

关键词: Stroke;    Oropharyngeal dysphagia;    Post stroke dysphagia;    Aspiration;    Pneumonia;   

DOI  :  10.1186/s42466-023-00233-z

 received in 2022-12-17, accepted in 2023-02-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPost-stroke dysphagia (PSD) is common and can lead to serious complications. Pharyngeal sensory impairment is assumed to contribute to PSD. The aim of this study was to investigate the relationship between PSD and pharyngeal hypesthesia and to compare different assessment methods for pharyngeal sensation.MethodsIn this prospective observational study, fifty-seven stroke patients were examined in the acute stage of the disease using Flexible Endoscopic Evaluation of Swallowing (FEES). The Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and impaired secretion management according to the Murray-Secretion Scale were determined, as well as premature bolus spillage, pharyngeal residue and delayed or absent swallowing reflex. A multimodal sensory assessment was performed, including touch-technique and a previously established FEES-based swallowing provocation test with different volumes of liquid to determine the latency of swallowing response (FEES-LSR-Test). Predictors of FEDSS, Murray-Secretion Scale, premature bolus spillage, pharyngeal residue, and delayed or absent swallowing reflex were examined with ordinal logistic regression analyses.ResultsSensory impairment using the touch-technique and the FEES-LSR-Test were independent predictors of higher FEDSS, Murray-Secretion Scale, and delayed or absent swallowing reflex. Decreased sensitivity according to the touch-technique correlated with the FEES-LSR-Test at 0.3 ml and 0.4 ml, but not at 0.2 ml and 0.5 ml trigger volumes.ConclusionsPharyngeal hypesthesia is a crucial factor in the development of PSD, leading to impaired secretion management and delayed or absent swallowing reflex. It can be investigated using both the touch-technique and the FEES-LSR-Test. In the latter procedure, trigger volumes of 0.4 ml are particularly suitable.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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