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Int Arch Otorhinolaryngol 2012; 16(04): 502-508
DOI: 10.7162/S1809-97772012000400012
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Pharyngeal swallowing phase and chronic cough

Daniela Rejane Constantino Drozdz
1   Speech Language Pathologist, Specialist in Oral Motricity approach with hospital. Master student of the Post-graduation Program in Human Communication Disorders, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul.
,
Cintia Conceição Costa
2   Speech Language Pathologist post-graduation. Master student of the Post-graduation Program in Human Communication Disorders, Federal University of Santa Maria Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
,
Paulo Roberto de Oliveira Jesus
3   Radiologist Doctor. Chief of the Radiology service of the Academic Hospital of Santa Maria (HUSM), Santa Maria, Rio Grande do Sul, Brazil.
,
Mateus Silva Trindade
4   Radiology Technician.
,
Guilherme Weiss
5   Physical Specialist in Radiology Diagnostic by the ABFM. Physical specialist in radiology diagnostic by the ABFM.
,
Abdias Baptista M. Neto
6   Pulmonologist Doctor.
,
Ana Maria T. da Silva
7   Speech Language Pathologist (SLP); Associate Professor of the Phonoaudiology Department of the Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil, PhD.
,
Renata Mancopes
8   Speech Language Pathologist (SLP), Adjunct Professor of the Post-Graduation Program in Human Communication Disorders, Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil, PhD.
› Author Affiliations
Further Information

Publication History

30 June 2012

26 August 2012

Publication Date:
10 December 2013 (online)

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Summary

Introduction: The act of swallowing depends on a complex and dynamic process which uses common structures to the act of breathing; respiratory problems can cause swallowing difficulties.

Aim: To assess the swallowing pharyngeal phase in patients with chronic cough.

Method: Retrospective study with 15 patients of both genders, patients with chronic cough and risk factors for aspiration defined by the pneumologic diagnosis. The patients were submitted to anamnesis on complaints related to swallowing, chewing and breathing, or related to food and to videofluoroscopic examination.

Results: It was observed that 33.3% had normal and functional swallowing, being the last one of most prevalence. The mild dysphagia was observed in 20% of the patients, the mild to moderate dysphagia in 6.7% of them. In relation to the Rosenbek scale, 73.3% of patients presented degree 1, 6.7% presented degrees 2 and 3, and 13.3% presented degree 8. The most found pathology was the chronic cough with 40%, followed by asthma with 20%; 69.2% of patients presented stasis and of these, five used protection maneuvers, of these, seven were effective and only three were used in the presence of stasis. The most used maneuver was the multiple swallowing, being effective in 100%.

Conclusion: There are peculiarities in the patients' swallowing with chronic cough that, although not presenting complaints relating to swallowing, it presents an important aspiration risk due to the presence of changes in breathing pattern that can intervene in the coordination between breathing and swallowing, which is essential to protect the lower airway.

Keywords

deglutition disorders - fluoroscopy - methods - cough
 

  • References

  • 1 Prodomo LPV, Angelis EC, Barros ANP. Avaliação clínica fonoaudiológica das disfagias. In: Jotz GP, Angelis EC, Barros APB. Tratado da deglutição e disfagia: no adulto e na criança. Rio de Janeiro: Revinter; 2010. . cap 6. p. 61–67
    Google Scholar
  • 2 Marchesan IQ. O que se considera normal na deglutição. In: Jacobi JS, Levy DS, Silva LMC. Disfagia avaliação e tratamento. Rio de Janeiro: Revinter; 2003. . cap 1. p.3–18
    Google Scholar
  • 3 Andrade CRF. Processamento motor- Padrão de organização da mastigação e deglutição. In: Andrade CRF, Limongi SCO. Disfagia prática baseada em evidências. São Paulo: Sarvier; 2012. . cap.3. p. 24–31
    Google Scholar
  • 4 Jotz GP, Dornelles S. Fisiologia da deglutição. In: Jotz GP, Angelis EC, Barros APB. Tratado da deglutição e disfagia: no adulto e na criança. Rio de Janeiro: Revinter; 2010. . cap. 2. p.16–20.
    Google Scholar
  • 5 Gonçalves MIR, César SR. Disfagias neurogênicas: Avaliação. In: Ortiz KZ, . (Org). Distúrbios neurológicos adquiridos. Barueri – SP: Manole; 2010. . c. 14. p. 278–301
    Google Scholar
  • 6 Silva RG. Disfagia orofaríngea pós acidente vascular encefálico. In: Ferreira LP, , et al. Tratado de Fonoaudiologia. São Paulo: Roca; 2004. . cap.5. p. 354–355
    Google Scholar
  • 7 Souza BBA , et al. Nutrição e disfagia: Guia para profissionais. Curitiba – PR: Nutroclínica; 2003. . cap.5. p. 17–22
    Google Scholar
  • 8 Swanson PB, Carrau RL, Murry T. Avaliação da deglutição com fibroendoscópio – FEES. In: Jotz GP, Angelis EC, Barros APB. Tratado da deglutição e disfagia. Rio de Janeiro: Revinter; 2010. . cap. 9. p. 76–81
    Google Scholar
  • 9 Miller CD, Rebuck JA, Ahern JW, Rogers FB. Daily evaluation of macroaspiration in the critically Ill post-trauma patient. Current Surgery 2005; 62 (5) 504-508
    CrossrefGoogle Scholar
  • 10 Marik PE. Primary Care: Aspiration pneumonitis and aspiration pneumonia. The New England Journal of Medicine 2001; 334 (9) 665-671
    Google Scholar
  • 11 Lopes FO. Tratado de Fonaudiologia. São Paulo: Tecmedd; 2005. . 2ed.
    Google Scholar
  • 12 Fleming CM, Shepard JO, Mark EJ. Case 15-2003: A 47-year-old man with waxing and waning pulmonary nodules five years after treatment for testicular seminoma. The New England Journal of Medicine 2003; 348 (20) 2019-2027
    CrossrefGoogle Scholar
  • 13 Gross RD, Atwood Jr CW, Ross SB, Olszewski JW, Eichhorn KA. The coordination of breathing and swallowing in chronic obstructive pulmonary Disease. Am J Respir Crit Care Med 2009; 179 (7) 559-65
    CrossrefGoogle Scholar
  • 14 Palombini BC , et al. Recentes progressos no diagnóstico diferencial da tosse crônica. Rev Bras Clín Ter 1997; 23 (2) 40-2
    Google Scholar
  • 15 Andrade CRF. Prática Baseada em Evidência na Disfagia. In: Andrade CRF, Limongi SCO. Disfagia Prática Baseada em Evidências. São Paulo: Sarvier; 2012. . cap. 1. p. 3–6
    Google Scholar
  • 16 Cardoso MCAF, Fontoura EG. Valor da auscuta cervical em pacientes acometidos por disfagia neurogênica. Arq. Int. Otorrinolaringol 2009; 13 (4) 431-9
    Google Scholar
  • 17 Furkim AM. Silva, RG. Programas de Reabilitação em Disfagia Neurogênica. In: Furkim AM, Santini CS. Disfagias Orofaríngeas. São Paulo: Pró – Fono; 1999
    Google Scholar
  • 18 O'Neil KH, Purdy M, Falk J, Gallo L. The dysphagia outcome and severity scale. Dysphagia 1999; 14: 139-145
    CrossrefPubMedGoogle Scholar
  • 19 Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia 1996; 11: 93-8
    Google Scholar
  • 20 Paintal HS, Kuschner WG. Aspiration syndromes: 10 clinical pearls every physician should know. International Journal of Clinical Practice 2007; 61 (5) 846-852
    CrossrefGoogle Scholar
  • 21 Dantas RO, Cassiani RA, Santos CM, Gonzaga GC, Alves LMT, Mazin SC. Effect of gender on swallow event duration assessed by videofluoroscopy. Dysphagia 2009; 24: 280-4
    CrossrefGoogle Scholar
  • 22 Prodomo LPV. Caracterização videofluoroscópica da fase faríngea da deglutição [ tese de doutorado]. São Paulo (SP): Fundação Antonio Prudente; 2010
    Google Scholar
  • 23 Chaves RD, Carvalho CRF, Cukier A, Stelmach R, Andrade CRF. Indicadores de disfagia na doença pulmonar obstrutiva crônica. In: Andrade CRF, Limongi SCO. Disfagia Prática Baseada em Evidências. São Paulo: Sarvier; 2012. . cap.13. p. 151–166
    Google Scholar
  • 24 Kolb G, Bröker M. State of the art in aspiration assessment and the idea of a new non invasive predictive test for the risk of aspiration in stroke. The Journal of Nutrition, Health & Aging© 2009; 13 (5) 429-433
    Google Scholar
  • 25 Kijima M, Isono S, Nishino T. Coordination of swallowing and phases of respiration during added respiratory loads in awake subjects. American Journal of Respiratory and Critical Care Medicine 1999; 159: 1989-1902
    Google Scholar
  • 26 Coelho CA . 1987 apud Chaves RD, Carvalho CRF, Cukier A, Stelmach R, Andrade CRF. Sintomas indicativos de disfagia em portadores de DPOC. J Bras Pneumol 2011; 37 (2) 176-183
    Google Scholar
  • 27 Silva LMC, Jacobi JS. Disfagia orofaríngea e sua importância na pneumologia. In: Jacobi JS, Levy DS, Silva LMC. Disfagia avaliação e tratamento. Rio de Janeiro: Revinter; 2003. . cap. 12. p. 163–180
    Google Scholar
  • 28 Person OC, Cerchiari DP, Zanini RVR, Santos RO, Rapoport PB. Cisto de base de língua como causa de tosse crônica. Arq Med ABC 2005; 31 (1) 35-7
    Google Scholar
  • 29 Langmore SE , et al. Predictors of aspiration pneumonia: how important is dysphagia?. Dysphagia 1998; 13 (2) 69-81
    CrossrefGoogle Scholar
  • 30 Dyer JC, Leslie P, Drinnan MJ. Objective computer-based assessment of valleculae residue—is it useful?. Dysphagia 2008; 23 (1) 7-15
    CrossrefGoogle Scholar
  • 31 Eisenhuber E , et al. Videofluoroscopic assessment of patients with dysphagia: Pharyngeal retention is a predictive factor for aspiration. AJR Am J Roentgenol 2002; 178 (2) 393-8
    CrossrefGoogle Scholar