Voluntary Swallowing Initiation Difficulty After Dorsomedial Prefrontal Cortex Damage: A Case Report.

The dorsomedial prefrontal cortex plays a critical role in movement initiation, and damage to this area can impair this function. Here we present the case of an individual who had difficulty with voluntary initiation of liquid swallowing after surgical removal of a glioblastoma from the right dorsomedial prefrontal cortex. This individual had no difficulty swallowing solids, perhaps because of the additional external movement triggers (eg, chewing) involved.

Effectiveness of rehabilitation for young patients with extensive right hemisphere cerebral infarction: A report of two cases.

Key Clinical Message: In younger patients, including those with extensive infarction involving the anterior and middle cerebral artery regions of the right hemisphere, appropriate treatment for rare causes and goal-oriented long-term rehabilitation could improve severe hemiplegia and higher brain dysfunction, and allow for further education and employment.

Abstract: Although the number of young stroke patients is small, many have serious sequelae and rare causes. In addition to independence in activities of daily living, education and employment are desired.

Articulatory-based Phonemic Paraphasia in Conduction Aphasia: A Dysfunction in Phoneme-to-Articulation Conversion Uncovered Through Crossed Aphasia.

Phonemic paraphasia, a common characteristic of conduction aphasia, has traditionally been attributed to phonological representation dysfunction. An alternative hypothesis posits that phonemic paraphasia arises from difficulty converting phonemes into their corresponding articulatory maneuvers. However, detailed case studies supporting this theory have been lacking.

Classification of sequential swallowing types using videoendoscopy with high reproducibility and reliability.

Objective: This study aimed to classify sequential swallowing types using videoendoscopy (VE) avoiding radiation exposure and compare the results using videofluoroscopy (VF).

Design: Twenty-one healthy adults simultaneously underwent VF and VE during sequential straw drinking. Each discrete swallow was classified into an L-segmental type (laryngeal vestibule opens after swallow) or L-continuous type (laryngeal vestibule closure continues after swallow) using VF and a V-segmental type (velopharynx opens after swallow) or V-continuous type (velopharynx closure continues after swallow) using VE.

Laterality of bolus passage through the pharynx in patients with unilateral medullary infarction.

Laterality of bolus passage in the pharynx is often seen in patients with medullary infarction. We evaluated the dominant side of bolus passage in the pharynx and investigated the factors that cause the passage to dominantly occur on the affected side. Forty-one patients (35 men and 6 women, 64 ± 9 years) with unilateral medullary infarction participated in this study.

The effect of bolus viscosity on laryngeal closure in swallowing: kinematic analysis using 320-row area detector CT.

The present study examined the effect of bolus viscosity on the onset of laryngeal closure (relative to hyoid elevation), the duration of laryngeal closure, and other key events of swallowing in ten healthy volunteers. All volunteers underwent 320-row area detector computed tomography swallow studies while swallowing 10 ml of honey-thick barium (5 % v/w) and thin barium (5 % v/w) in a 45° reclining position. Three-dimensional images of both consistencies were created in 29 phases at an interval of 0.

Hyoid bone and larynx movements during electrical stimulation of motor points in laryngeal elevation muscles: a preliminary study.

Objectives:   This study aimed to determine the laryngeal elevation muscle motor points, evaluate the movement of hyoid bone and larynx during stimulation of the motor points, and examine the potential for treating severe dysphagia by functional electrical stimulation.

Methods:   The motor points of the laryngeal elevation muscles were anatomically determined from four cadavers. Those motor points in two healthy subjects and one lateral medullary syndrome patient were electrically stimulated by surface or implanted electrodes.

The secretion severity rating scale: a potentially useful tool for management of acute-phase fasting stroke patients.

This retrospective clinical investigation was conducted to evaluate the usefulness of the Secretion Severity Rating Scale (Secretion Scale) in predicting the risk of pneumonia in acute-phase fasting stroke patients. Videoendoscopic (VE) evaluation of swallowing was performed in 72 consecutive stroke patients with a nonoral status. The patients were classified into 2 groups based on the Secretion Scale: the pharyngeal residual group (n=38; Secretion Scale level 0, 8 [11.

Evaluation of swallowing using 320-detector-row multislice CT. Part II: kinematic analysis of laryngeal closure during normal swallowing.

The purpose of this study was to (1) depict normal dynamic swallowing and (2) measure (a) the temporal characteristics of three components of laryngeal closure, i.e., true vocal cord (TVC) closure, closure of the laryngeal vestibule at the arytenoid to epiglottic base, and epiglottic inversion, and (b) the temporal relationship between these levels of laryngeal closure and other swallowing events, hyoid elevation, and the pharyngoesophageal segment (PES) using 320-detector-row multislice computed tomography (320-MSCT).

Hyoid movement and laryngeal penetration during sequential swallowing.

This study examined hyoid movement during sequential swallowing and evaluated the relationship among trajectory patterns, swallowing types based on laryngeal movement and laryngeal penetration. Twelve healthy adults underwent videofluorography during sequential swallowing. Each swallow was classified into two types: opened laryngeal vestibule after swallow (i-Segmental type) and closed laryngeal vestibule after swallow (i-Continuous type).

Evaluation of swallowing using 320-detector-row multislice CT. Part I: single- and multiphase volume scanning for three-dimensional morphological and kinematic analysis.

A 320-detector-row multislice computed tomography (320-MSCT) scanner can acquire a volume data set covering a maximum range of 16 cm and can generate axial images 0.5-mm thick at 0.5-mm intervals.

Simple swallowing provocation test has limited applicability as a screening tool for detecting aspiration, silent aspiration, or penetration.

A number of tests for evaluating dysphagia without using videofluoroscopic examination of swallowing (VF) or videoendoscopic evaluation of swallowing (VE) have been developed. The simple swallowing provocation test (SSPT) is unique because it is performed while in a supine position and does not require the patient's cooperation. However, whether the SSPT detects aspiration or penetration correctly is unclear because its validity determined by VF or VE has not been evaluated.

Dysphagia rehabilitation in Japan.

This article describes the features of Japanese dysphagia rehabilitation, particularly where it differs from that in the United States. Many kinds of professionals participate in dysphagia rehabilitation; nurses and dental associates take important roles, and the Japanese insurance system covers that. Videofluorography and videoendoscopy are common and are sometimes done by dentists.

Development of an easily swallowed film formulation.

We have developed an easily swallowed film formulation that swells and turns into a jelly instantaneously upon absorption of a small amount of saliva. The formulation's structure comprises a gelating layer on both faces of a drug-containing layer, and this structure restrains the elution of a drug in the mouth. Swelling experiments confirmed the instantaneous gelation when the gelating layer absorbs purified water.

What is the chin-down posture? A questionnaire survey of speech language pathologists in Japan and the United States.

The "chin-down" or "chin-tuck" maneuver is a postural technique widely used in dysphagia treatment. The posture, however, does not have a precise anatomical definition. We studied the current practice of 42 speech-language pathologists (SLPs) in Japan and the U.

Chewing and food consistency: effects on bolus transport and swallow initiation.

Preswallow bolus formation usually occurs in the mouth for liquids and in the oropharynx for solid foods. We examined the effect of chewing on the relationship between bolus transport and swallow initiation. Fifteen healthy subjects were imaged with lateral projection videofluorography while eating liquids, solid foods, and a mixture of liquid and solid foods in upright and facedown postures.