대뇌 손상 위치에 따른 삼킴 시간과 침습 및 흡인 간의 관계

Abstract

Objectives: Although few study have attempted to identify temporal measurements of swallowing in unilateral stroke patients, the relationship between temporal measurements and aspiration-related swallowing dysfunction remain unknown. The aim of this study was to investigate the relationship between temporal measurements of pharyngeal swallowing and aspiration in unilateral stroke patients. Methods: We conducted a prospective study of 60 patients undergoing both videofluoroscopic swallowing examinations and brain magnetic resonance imaging scan studies. Patients were divided into two groups: group 1 included subacute stroke patients with left cerebral hemispheric lesions (N=27) and group 2 included subacute stroke patients with right cerebral hemispheric lesions (N=33). The results of temporal measurements of swallowing, including pharyngeal transit duration (PTD), initiation laryngeal closure (ILC), and laryngeal closure duration (LCD) and penetration-aspiration, were analyzed during 5-mL thin liquids swallowing task. To determine the optimum cut-off value along with the presence of penetration-aspiration, receiver operating characteristic (ROC) curve analysis was performed. Results: The right cerebral hemispheric lesion group showed significant association with delayed PTD and ILC. The cut-off values for PTD and ILC were 0. 71 seconds (p=.02) and 1.25 seconds (p=.008), respectively. Conclusion: ILC is the most valid predictor for penetration-aspiration occurrence in stroke patients with right cerebral hemispheric lesions. Penetration-aspiration events on swallows are affected by delayed laryngeal closure and pharyngeal transit duration.