Article

OBJECTIVE: To investigate whether the concomitant presence of anterior cervical
osteophytes can influence the severity and outcome of patients with poststroke
dysphagia. DESIGN: Retrospective case-control study. SETTING: Hospital.
PARTICIPANTS: A total of 40 participants were identified
(N=40). Patients with
poststroke dysphagia with anterior cervical osteophytes
(n=20) were identified
and matched by age, sex, location, and laterality of the stroke lesion to a
poststroke dysphagia control group with no anterior cervical osteophytes (n=20).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Videofluoroscopic
swallowing study, Functional Oral Intake Scale (FOIS), and Penetration-Aspiration
Scale results assessed within the first month of stroke were analyzed. The FOIS
at 6 months was recorded, and severity of dysphagia was compared between the 2
groups. RESULTS: The case group had larger degrees of postswallow residues in the
valleculae and pyriform sinuses (P=.020 and P<.001, respectively), with more
patients showing postswallow aspiration (62.5%) than the control group (0%;
P<.001), along with a higher risk of being on enteral nutrition feeding (odds
ratio [OR]=13.933; 95% confidence interval [CI], 2.863-infinity) within the first
month of stroke. At the 6-month follow-up, the case group had significantly lower
mean FOIS scores (3.8+/-1.7) than the control group (6.1+/-1.3; P<.001), with an
increased risk of having persistent dysphagia (OR=15.375; 95% CI,
3.195-infinity). CONCLUSIONS: The presence of anterior cervical osteophytes,
which may cause mechanical obstruction and interfere with residue clearance at
the valleculae and pyriform sinuses and result in more postswallow aspiration,
may influence initial severity and outcome of poststroke dysphagia. The presence
of anterior cervical osteophytes may be considered an important clinical
condition that may affect poststroke dysphagia rehabilitation.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS