J Korean Med Sci.  2011 Mar;26(3):425-430. 10.3346/jkms.2011.26.3.425.

Usefulness of Videofluoroscopic Swallow Study with Mixed Consistency Food for Patients with Stroke or Other Brain Injuries

• Kang SH
• Kim DK
• Seo KM
• Seo JH

• KMID: 2157882
• DOI: http://doi.org/10.3346/jkms.2011.26.3.425

Abstract

This study evaluated the feasibility of mixed consistency foods test in patients with dysphagia which developed after stroke or other brain injuries. The findings of a videofluoroscopic swallow study (VFSS) were compared using single versus mixed consistency foods. Forty-nine patients with stroke or other brain injuries who had no significant abnormal findings in the single consistency food VFSS and started regular hospital diet were recruited for this study. Twenty-five (51%) of the 49 patients showed normal findings whereas 24 (49%) patients showed abnormal findings in the mixed consistency food VFSS. Abnormal findings included posterior spillage of liquid prematurely to pyriform sinus (n = 23), laryngeal penetration (n = 6), subglottic aspiration in the oral preparatory phase of swallowing (chewing), solid components (n = 2), and significant (more than 10%) residue in valleculae or pyriform sinus (n = 2). There was an increased risk of abnormal findings in mixed consistency food VFSS such as aspiration and penetration when a patient showed delayed pharyngeal delay time in single consistency food using liquids. In conclusion, VFSS protocols using mixed consistency foods would be useful before starting regular diet for patients after stroke or other brain injuries.

Keyword

Dysphasia; Stroke; Brain Injuries; Fluoroscopy; Diet; Food

MeSH Terms

Brain Injuries/*physiopathology/radiography
*Deglutition
Deglutition Disorders/*physiopathology/radiography
*Eating
Fluoroscopy/*methods
Food
Humans
Mastication
Stroke/*physiopathology/radiography
Video Recording

Figure

• 

  Fig. 1 Regular Korean hospital diet. It is steamed rice (red*) and a soup (red**) composed of thin liquid and various vegetables, tofu, etc. Several side dished could be added (A). Many Korean prefer mixture of the rice with soup (B). A picture of a scoop of the mixture (C).

• 

  Fig. 2 Mixed (dual) consistency food for VFSS. (A) 4 mL of thin liquid barium, (B) 4 g of steamed rice, (C) the mixture.

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  Fig. 3 Mixed consistency VFSS in control group. (A) Two subjects of control group showed posterior spillage of liquid (arrow) during oral phase, (B) Immediately the pharyngeal swallowing reflex was triggered and they swallowed the liquid component and continued chewing of solid component (arrowheads).

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  Fig. 4 Mixed consistency VFSS in patient group. Abnormal findings were found such as (A) Premature liquid posterior spillage (arrow) in the oral phase of swallowing of solid component (arrowheads) (B) Subglottic aspiration (arrow) in the oral preparatory phase (chewing) of solid component (arrowheads).

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