Upper Esophageal Sphincter Opening During Swallow in Stroke Survivors

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ObjectiveTimely and efficient upper esophageal sphincter (UES) opening may be critical to safe transport of food or liquid to the stomach and to prevent aspiration during the swallow. The purpose of this study was to examine the temporal and biomechanical characteristics of the UES opening in stroke survivors.MethodMaximum duration and width of the UES opening were obtained from 15 stroke survivors with aspiration and 15 stroke survivors with no aspiration. The control group was composed of 15 normal subjects undergoing videofluoroscopic swallowing examinations. The videofluoroscopic swallowing examination protocol was as follows: two swallows of 5 ml thin liquid and two swallows of 10 ml thin liquid. Statistical comparisons were made by repeated measurements of analysis of variance, and the significance level was set at P < 0.025.ResultThe stroke survivors with aspiration, the stroke survivors without aspiration, and the control group differed significantly for duration of UES opening (P < 0.01) but not maximum width of UES opening.ConclusionProlonged UES opening may be related to prolonged pharyngeal transition of the bolus and slower UES muscle contraction and hyolaryngeal excursion after stroke.

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