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[Dysphagia] vital stim
See:
http://www.asha.org/about/publications/leader-online/archives/2004/040316/040316c.htm
http://www.slpab.ca.gov/licensing/electrical_stimulation.htm
http://www.asha.org/about/publications/leader-online/archives/2004/040413/040413d.htm
http://www.clinicaltrials.gov/ct/gui/show/NCT00001936
and, BTW, if I read one more time that "laryngeal elevation opens the UES" I may just become a candidate for a jacket that buttons up the back! This sort of sloppy, incorrect language leads to sloppy thinking. If one believes that laryngeal elevation has anything to do with UES opening it leads to profound errors in identifying the cause of the symptom, dysphagia. The larynx elevates ONLY because of movement of the hyoid (the salpingopharyngeus notwithstanding) and it is anterior HYOID movement that opens the UES. See publications by Kahrilas, Logemann, Rademaker and many others, mostly in the American Journal of Physiology over the past ten years. And, while I'm on the subject, see the current issue of Dysphagia for one of the most important articles on the topic published so far:
Airway Protection: Evaluation with Videofluoroscopy
Katherine A. Kendall, Rebecca J. Leonard and Susan McKenzie
Abstract "During videofluoroscopic swallowing studies performed in the lateral view, the arytenoid cartilages are seen to elevate and approximate the down-folding epiglottis, effectively closing the supraglottic larynx and protecting the airway. This mechanism may be incomplete or delayed in patients complaining of dysphagia and may lead to penetration of bolus material into the airway. This study evaluates the timing of supraglottic closure relative to the arrival of the bolus at the upper esophageal sphincter in 60 young control subjects and in 63 elderly control subjects without dysphagia. "
Since arytenoid movement provides the major protection of the airway, I have to wonder why I never see it mentioned in the scores of reports I read constantly.
Irene.
"A.B.J." <kuakini2001@yahoo.com> wrote:
Our Rehab Manager is interested in purchasing a vital stim unit. I am far from convinced of the efficacy of vital/electrical stim in rehabilitating swallowing. I have reviewed the postings in the archives, which were helpful. I am looking for recent articles/literature and would greatly appreciate any recommendations.
thank you
April
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