Ann Rehabil Med.  2013 Oct;37(5):633-641. 10.5535/arm.2013.37.5.633.

Comparison of Swallowing Functions Between Brain Tumor and Stroke Patients

• Park DH
• Chun MH
• Lee SJ
• Song YB

• KMID: 2266580
• DOI: http://doi.org/10.5535/arm.2013.37.5.633

Abstract

OBJECTIVE
To compare the swallowing functions according to the lesion locations between brain tumor and stroke patients.
METHODS
Forty brain tumor patients and the same number of age-, lesion-, and functional status-matching stroke patients were enrolled in this study. Before beginning the swallowing therapy, swallowing function was evaluated in all subjects by videofluoroscopic swallowing study. Brain lesions were classified as either supratentorial or in-fratentorial. We evaluated the following: the American Speech-Language-Hearing Association (ASHA) National Outcome Measurement System (NOMS) swallowing scale, clinical dysphagia scale, functional dysphagia scale (FDS), penetration-aspiration scale (PAS), oral transit time, pharyngeal transit time, the presence of vallecular pouch residue, pyriform sinus residue, laryngopharyngeal incoordination, premature spillage, a decreased swal-lowing reflex, pneumonia, and the feeding method at discharge.
RESULTS
The incidence of dysphagia was similar in brain tumor and stroke patients. There were no differences in the results of the various swallowing scales and other parameters between the two groups. When compared brain tumor patients with supratentorial lesions, brain tumor patients with infratentorial lesions showed higher propor-tion of dysphagia (p=0.01), residue (p<0.01), FDS (p<0.01), PAS (p<0.01), and lower ASHA NOMS (p=0.02) at initial evaluation. However, there was no significant difference for the swallowing functions between benign and malig-nant brain tumor patients.
CONCLUSION
Swallowing function of brain tumor patients was not different from that of stroke patients according to matching age, location of lesion, and functional status. Similar to the stroke patients, brain tumor patients with infratentorial lesions present poor swallowing functions. However, the type of brain tumor as malignancy does not influence swallowing functions.

Keyword

Brain tumor; Dysphagia; Videofluoroscopic swallowing study; Infratentorial lesion; Malignancy

MeSH Terms

American Speech-Language-Hearing Association
Ataxia
Brain Neoplasms*
Brain*
Deglutition Disorders
Deglutition*
Feeding Methods
Humans
Incidence
Pneumonia
Pyriform Sinus
Reflex
Stroke*
Weights and Measures

Reference

1. Vargo M. Brain tumor rehabilitation. Am J Phys Med Rehabil. 2011; 90(5 Suppl 1):S50–S62. PMID: 21765264.

2. Wesling M, Brady S, Jensen M, Nickell M, Statkus D, Escobar N. Dysphagia outcomes in patients with brain tumors undergoing inpatient rehabilitation. Dysphagia. 2003; 18:203–210. PMID: 14506986.

3. Perlman AL. Dysphagia in stroke patients. Semin Neurol. 1996; 16:341–348. PMID: 9112313.

4. Lee CK, Kim JA. Pattern of post-stroke swallowing disorder according to the brain lesion. J Korean Acad Rehabil Med. 2001; 25:193–201.

5. Robbins J, Levine RL, Maser A, Rosenbek JC, Kempster GB. Swallowing after unilateral stroke of the cerebral cortex. Arch Phys Med Rehabil. 1993; 74:1295–1300. PMID: 8259895.

6. Logemann JA. Manual for the videofluorographic study of swallowing. 2nd ed. Austin: Pro-Ed;1993.

7. Pietila S, Korpela R, Lenko HL, Haapasalo H, Alalantela R, Nieminen P, et al. Neurological outcome of childhood brain tumor survivors. J Neurooncol. 2012; 108:153–161. PMID: 22350432.

8. O'Neil KH, Purdy M, Falk J, Gallo L. The dysphagia outcome and severity scale. Dysphagia. 1999; 14:139–145. PMID: 10341109.

9. Han TR, Paik NJ, Park JW. The clinical functional scale for dysphagia in stroke patients. Korean J Stroke. 2001; 3:153–157.

10. Han TR, Paik NJ, Park JW. Quantifying swallowing function after stroke: a functional dysphagia scale based on videofluoroscopic studies. Arch Phys Med Rehabil. 2001; 82:677–682. PMID: 11346847.

11. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996; 11:93–98. PMID: 8721066.

12. Lin CW, Chang YC, Chen WS, Chang K, Chang HY, Wang TG. Prolonged swallowing time in dysphagic Parkinsonism patients with aspiration pneumonia. Arch Phys Med Rehabil. 2012; 93:2080–2084. PMID: 22846454.

13. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007; 114:97–109. PMID: 17618441.

14. Huang ME, Cifu DX, Keyser-Marcus L. Functional outcome after brain tumor and acute stroke: a comparative analysis. Arch Phys Med Rehabil. 1998; 79:1386–1390. PMID: 9821898.

15. Battistella PA, Ruffilli R, Viero F, Bendagli B, Condini A. Brain tumors: classification and clinical aspects. Pediatr Med Chir. 1990; 12:33–39. PMID: 2198549.

16. Purdy RA, Kirby S. Headaches and brain tumors. Neurol Clin. 2004; 22:39–53. PMID: 15062527.

17. Brown JM, Deriso DM, Tansey KE. From contemporary rehabilitation to restorative neurology. Clin Neurol Neurosurg. 2012; 114:471–474. PMID: 22538268.

18. Wang XF, Zhang S, Ye YH, Chen YP, Liu XY. Clinicopathologic features of delayed radiation-induced brain injury after radiotherapy for brain tumor. Zhonghua Bing Li Xue Za Zhi. 2012; 41:224–228. PMID: 22800516.

19. Ouyang M, McDonagh DL, Phillips-Bute B, James ML, Friedman AH, Gan TJ. Does midline shift predict postoperative nausea in brain tumor patients undergoing awake craniotomy? A retrospective analysis. Curr Med Res Opin. 2013; 29:1033–1038. PMID: 23731200.

20. Bebawy JF. Perioperative steroids for peritumoral intracranial edema: a review of mechanisms, efficacy, and side effects. J Neurosurg Anesthesiol. 2012; 24:173–177. PMID: 22544067.

21. Kim YZ, Kim DY, Yoo H, Yang HS, Shin SH, Hong EK, et al. Radiation-induced necrosis deteriorating neurological symptoms and mimicking progression of brain metastasis after stereotactic-guided radiotherapy. Cancer Res Treat. 2007; 39:16–21. PMID: 19746231.

22. Sghirlanzoni A, Silvani A, Scaioli V, Pareyson D, Marchesan R, Boiardi A. Cisplatin neuropathy in brain tumor chemotherapy. Ital J Neurol Sci. 1992; 13:311–315. PMID: 1318287.

23. Amato AA, Collins MP. Neuropathies associated with malignancy. Semin Neurol. 1998; 18:125–144. PMID: 9562674.