The relationship between dysphagia in ischemic stroke survivors and the site of their lesions / 中华物理医学与康复杂志

ABSTRACT

Objective:To explore the relationship between dysphagia and the lesion site after an ischemic stroke.Methods:The records of 178 cerebral infarction patients were divided into a supratentorial group of 111 and an infratentorial group of 67, according to the site of their lesions. The supratentorial group was further divided into left, right and bilateral groups of 59, 34 and 18, respectively. Fluoroscopic videos of the patients′ swallowing were used to measure lip closure, bolus formation, apraxia, tongue-to-palate contact, premature bolus loss, oral transit time, triggering of pharyngeal swallowing, vallecular residue, larynx elevation, pyriform sinus residue, pharynx wall coating, pharynx transit time, aspiration, and leakage.Results:There were significant differences between the supratentorial and infratentorial groups in bolus formation, apraxia, oral transit time, triggering of pharyngeal swallowing, larynx elevation, and aspiration. Moreover, significant differences were found in the incidence of aspiration among the left, right and bilateral supratentorial groups.Conclusions:Patients with supratentorial infarction are more likely than those with infratentorial infarction to develop oral dysphagia, including poor bolus formation, apraxia and prolonged oral transit time. Those with infratentorial infarction are more likely to have pharyngeal dysphagia, including poor triggering of pharyngeal swallowing, obstructed larynx elevation, and aspiration. Those with bilateral cerebral hemisphere infarction are more likely to aspirate than those with an infarct in the left cerebral hemisphere.