Pharyngoesophageal Segment Distention Across Volumes and Pathology.

Purpose: Patients receive multiple bolus trials during a videofluoroscopic swallowing study (VFSS) to assess swallow function, inclusive of narrowing within the pharyngoesophageal segment (PES). While differences in the narrowest and widest segments are visualized, the ratio of distention across bol...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 63; no. 11; pp. 3594 - 3600
Autores principales: Logan, Ashley M., Gawlik, Alexandria E., Aden, James K., Jarvis, Natalie C., Dion, Gregory R.
Formato: Artículo
Publicado: American Speech-Language-Hearing Association Nov2020
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2020
      vid: 63
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      pub: American Speech-Language-Hearing Association
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        10.1044/2020_JSLHR-19-00401
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        atl: Pharyngoesophageal Segment Distention Across Volumes and Pathology.
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        au:
          Logan, Ashley M.
          Gawlik, Alexandria E.
          Aden, James K.
          Jarvis, Natalie C.
          Dion, Gregory R.
        affil:
          Department of Otolaryngology--Head and Neck Surgery, Brooke Army Medical Center, Joint Base San Antonio--Fort Sam Houston, TX
          Department of Surgery, Brooke Army Medical Center, Joint Base San Antonio--Fort Sam Houston, TX
          Dental and Craniofacial Trauma Research Department, U.S. Army Institute of Surgical Research, Joint Base San Antonio--Fort Sam Houston, TX
      su:
        Retrospective studies
        Esophagus
        Esophageal diverticula
        Fluoroscopy
        Longitudinal method
        Pharynx
        Speech therapy
        Phenotypes
        Data analysis software
        Descriptive statistics
      sug:
        subj:
          Retrospective studies
          Esophagus
          Esophageal diverticula
          Fluoroscopy
          Longitudinal method
          Pharynx
          Speech therapy
          Phenotypes
          Data analysis software
          Descriptive statistics
      ab: Purpose: Patients receive multiple bolus trials during a videofluoroscopic swallowing study (VFSS) to assess swallow function, inclusive of narrowing within the pharyngoesophageal segment (PES). While differences in the narrowest and widest segments are visualized, the ratio of distention across boluses is not well understood. Method: A retrospective review of 50 consecutive VFSSs with five boluses of varied viscosity and volume was performed. Still images at maximal PES distention were captured and scaled using a 19-mm disk. Measurements of the narrowest and widest segments were obtained, and a distention ratio was calculated. Studies were categorized by PES phenotype as normal, esophageal web, cricopharyngeal bar, or narrow PES. PES distention ratios were evaluated across bolus trials and within PES phenotypes using a mixed-methods repeated-measures analysis of variance. Results: Of the 50 studies, there were 11 normal, 16 web, 10 bar, and 13 narrow PES. Quantitative differences were present for the narrowest (p = .01) and widest (p = .002) points across bolus volumes. No difference was present in distention ratio (p = .2) across volumes. Evaluating the PES phenotype, web, normal, bar, and narrow PES distention ratios differed (p = .03). Bar and PES narrow distention ratios were lower compared to that of the normal group (p = .01 for normal vs. bar and p = .02 for normal vs. PES narrow). Conclusions: PES distention ratio stability across varying bolus volumes and phenotypes suggests that a reduction in trials during a VFSS may permit an equivalent PES evaluation to traditional exams. Ultimately, this could improve our understanding and accurate diagnosis of PES dysfunction.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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