Videofluoroscopy of swallowing in symptomatic patients who have undergone long-term intubation

OBJECTIVE. The aim of this study was to evaluate whether specific patterns of swallowing dysfunction occur in symptomatic patients after long-term int ubation. SUBJECTS AND METHODS. Twenty-one patients (16 men, five women; mean age, 66 years) who presented with clinical signs of aspiration after long-term int ubation (mean duration, 24.6 days) underwent videofluoroscopy. They were an alyzed for functional abnormalities of the tongue, soft palate, epiglottis, hyoid and larynx, pharynx, and the upper esophageal sphincter. We assessed the presence or absence of aspiration, the type of aspiration (pre-, intra -, and postdeglutitive), and a spectrum of other swallowing abnormalities. RESULTS, There were 18 patients (86%) with radiologically proven aspiration . In another patient only laryngeal penetration occurred. There were 11 com binations of pre-, intra-, and postdeglutitive aspiration. Predeglutitive a spiration was predominant and present in 52% of our patients. We found func tional abnormalities of the tongue in 48%, of the soft palate in 10%, of th e epiglottis in 48%, of the pharynx in 71%, and of the upper esophageal sph incter in 24%, CONCLUSION. Patients who are symptomatic after undergoing long-term intubat ion do not develop a specific type or pattern of swallowing dysfunction or aspiration, but show a large variety of aspiration types and associated swa llowing disorders. Nevertheless, videofluoroscopy has the ability to reveal complex deglutition disorders and to aid precise planning of individualize d functional swallowing therapy.