Establishment of an oropharyngeal dysphagic patient's simple screening method using an ultrasonic device.

2004 Fiscal Year Final Research Report Summary

• Project/Area Number: 13671966
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: 病態科学系歯学(含放射線系歯学)
• Research Institution: HIROSHIMA UNIVERSITY
• Principal Investigator: NAITOU Kumiko Hiroshima university, Graduate School of Biomedical Sciences, Research assistant, 大学院・医歯薬学総合研究科, 助手 (10155632)
• Co-Investigator(Kenkyū-buntansha): NAGASAKI Toshikazu (YAMADA Toshikazu) Hiroshima university, Graduate School of Biomedical Sciences, Research assistant, 大学院・医歯薬学総合研究科, 助手 (10263724) ; OHTSUKA Masahiko Hiroshima university, Graduate School of Biomedical Sciences, Research assistant, 大学院・医歯薬学総合研究科, 助手 (20233182) ; TAGUCHI Akira Hiroshima university, Hiroshima university hospital, Instructor, 病院・講師 (70243582) ; SUEI Yoshikazu Hiroshima university, Hiroshima university hospital, Instructor, 病院・講師 (10206378) ; TANIMOTO Keiji Hiroshima university, Graduate School of Biomedical Sciences, Professor, 大学院・医歯薬学総合研究科, 教授 (10116626)
• Project Period (FY): 2001 – 2004
• Keywords: ultrasonic devise / swallowing / piriform sinus

Research Abstract

In order to establish the measurement item for the simple screening method using a ultrasonic device, the relationship of the VF picture view and prognosis was investigated for 31 65-year-old elderly people (28 men, 15 women, 85 years old of average age) who have consciousness disorder among the patients of one extended care unit who suspected incorrect dysphagic pneumonia by generation of heat, and conducted deglutition imaging inspection. The prognosis judging was taken as the bad prognosis, when it died within half a year one month after swallowing examination.
There were nine bad prognoses. All cases versus the bad prognosis considered to be an unusual image by deglutition imaging inspections, of the tongue-velum unclosure during swallowing, pharynx remains after swallowing, swallowing reflex lengthy delay, and aspiration were 8 versus 7 persons, 11 versus 6 persons, 4 versus 2 persons, and 27 versus 9 persons, respectively. However, all aspiration's cases were small quantity.
As mentioned above, it was not made to a measurement item about the tongue velum closing insufficiency which can serve as a bad prognosis's indicator, and the pharynx remains after a swallowing.
10ml of contrast media was beforehand held to the mouth with the seating position posture, and the mandate deglutition was performed to three times in normal persons by whom the agreement was got with the study. Deglutition inspection conducted simultaneously ultrasonic picture inspection and X ray deglutition imaging inspection.
Tongue velum closing was possible among three persons at three persons. And the epiglottis valley was possible among three persons immediately after just before the maximum pharynx shrinkage at two persons.
Conclusion is the indicator for the simple screening method of a swallowing difficulty using a portable ultrasonic device - the existence of the tongue-velum closure line, and the existence of piriform sinus have high echo area - having been shown.