Brief Article
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World J Gastroenterol. Jun 21, 2012; 18(23): 2973-2978
Published online Jun 21, 2012. doi: 10.3748/wjg.v18.i23.2973
Investigation of compensatory postures with videofluoromanometry in dysphagia patients
Antonio Solazzo, Luigi Monaco, Lucia Del Vecchio, Stefania Tamburrini, Francesca Iacobellis, Daniela Berritto, Nunzia Luisa Pizza, Alfonso Reginelli, Natale Di Martino, Roberto Grassi
Antonio Solazzo, Francesca Iacobellis, Daniela Berritto, Nunzia Luisa Pizza, Alfonso Reginelli, Roberto Grassi, Department of Radiology Magrassi-Lanzara, Second University of Naples, 80138 Napoli, Italy
Luigi Monaco, Natale Di Martino, Department of Gerontology, Geriatrics and Metabolic Diseases, Second University of Naples, 80138 Napoli, Italy
Lucia Del Vecchio, Department of Pathology of the Head and Neck, Oral Cavity and Audio-verbal Communication, Second University of Naples, 80138 Napoli, Italy
Stefania Tamburrini, UOC Diagnostic Imaging, PO Pellegrini, 80134 Napoli, Italy
Author contributions: Solazzo A, Monaco L and Del Vecchio L designed and drafted the article; Reginelli A, Tamburrini S and Pizza NL analyzed and interpreted the data; Iacobellis F and Berritto D acquired and analyzed the data and critically revised the intellectual content of the article; Grassi R and Di Martino N approved the final version of the manuscript; and all authors approved the version for publication.
Correspondence to: Dr. Antonio Solazzo, Department of Radiology Magrassi-Lanzara, Second University of Naples, 80138 Napoli, Italy. antoniosolazzo@hotmail.it
Telephone: +39-81-5665203 Fax: +39-81-5665200
Received: August 20, 2011
Revised: September 26, 2011
Accepted: February 27, 2012
Published online: June 21, 2012
Abstract

AIM: To investigate the effectiveness of head compensatory postures to ensure safe oropharyngeal transit.

METHODS: A total of 321 dysphagia patients were enrolled and assessed with videofluoromanometry (VFM). The dysphagia patients were classified as follows: safe transit; penetration without aspiration; aspiration before, during or after swallowing; multiple aspirations and no transit. The patients with aspiration or no transit were tested with VFM to determine whether compensatory postures could correct their swallowing disorder.

RESULTS: VFM revealed penetration without aspiration in 71 patients (22.1%); aspiration before swallowing in 17 patients (5.3%); aspiration during swallowing in 32 patients (10%); aspiration after swallowing in 21 patients (6.5%); multiple aspirations in six patients (1.9%); no transit in five patients (1.6%); and safe transit in 169 patients (52.6%). Compensatory postures guaranteed a safe transit in 66/75 (88%) patients with aspiration or no transit. A chin-down posture achieved a safe swallow in 42/75 (56%) patients, a head-turned posture in 19/75 (25.3%) and a hyperextended head posture in 5/75 (6.7%). The compensatory postures were not effective in 9/75 (12%) cases.

CONCLUSION: VFM allows the speech-language the-rapist to choose the most effective compensatory posture without a trial-and-error process and check the effectiveness of the posture.

Keywords: Aspiration; Compensatory postures; Oropharyngeal dysphagia; Videofluoromanometry; Chin-down posture; Head-turned; Hyperextended head