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Upper Esophageal Sphincter Opening During Swallow in Stroke Survivors

Kim, Youngsun PhD, CCC-SLP; Park, Taeok MA; Oommen, Elizabeth PhD; McCullough, Gary PhD, CCC-SLP

American Journal of Physical Medicine & Rehabilitation: September 2015 - Volume 94 - Issue 9 - p 734–739
doi: 10.1097/PHM.0000000000000258
Original Research Articles

Objective Timely and efficient upper esophageal sphincter (UES) opening may be critical to safe transport of food or liquid to the stomach and to prevent aspiration during the swallow. The purpose of this study was to examine the temporal and biomechanical characteristics of the UES opening in stroke survivors.

Method Maximum duration and width of the UES opening were obtained from 15 stroke survivors with aspiration and 15 stroke survivors with no aspiration. The control group was composed of 15 normal subjects undergoing videofluoroscopic swallowing examinations. The videofluoroscopic swallowing examination protocol was as follows: two swallows of 5 ml thin liquid and two swallows of 10 ml thin liquid. Statistical comparisons were made by repeated measurements of analysis of variance, and the significance level was set at P < 0.025.

Result The stroke survivors with aspiration, the stroke survivors without aspiration, and the control group differed significantly for duration of UES opening (P < 0.01) but not maximum width of UES opening.

Conclusion Prolonged UES opening may be related to prolonged pharyngeal transition of the bolus and slower UES muscle contraction and hyolaryngeal excursion after stroke.

From the Communication Sciences and Disorders, Ohio University, Athens (YK, TP); Department of Speech Pathology and Audiology, Calvin College, Grand Rapids, Michigan (EO); and College of Health Sciences, Appalachian State University, Boone, North Carolina (GM).

All correspondence and requests for reprints should be addressed to: Youngsun Kim, PhD, CCC-SLP, Communication Sciences and Disorders, Grover Center W218, Ohio University, Athens, OH 45701-2979.

Supported, in part, by a grant from the Department of Veterans Affairs Office of Academic Affiliations and a grant from the Department of Veterans Affairs (VA RR&D C96-1143RA and C98-1142PA).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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