Videofluroscopia da deglutição no diagnóstico funcional da disfagia / Swallowing videofluoroscopy in the functional diagnosis of dysphagia

A videofluoroscopia da deglutição (VFD) é considerada o método gold standard para o estudo da deglutição, sendo considerada uma avaliação de referência por diversos centros de estudos da deglutição. É um método radiológico que permite observar a fisiologia da deglutição nas fases preparatória oral, faríngea e esofágica. A VFD fornece uma imagem bidimensional que permite avaliar objetivamente a dinâmica da deglutição com visualização de todas as fases. Esta informação irá sustentar a tomada de decisões sobre estratégias de intervenção durante a avaliação, avaliar a fisiologia e funcionalidade das fases oral, faríngea e esofágica, definir diagnósticos funcionais e sugerir recomendações para a dieta alimentar.

Reflexo estapédico em portadores de paralisia facial periférica antes e após intervenção fonoaudiológica / Stapedial reflex in patients with facial paralysis before and after phonoaudiological intervention

Objetivo: Comparar as características do reflexo estapédico em portadores de paralisia facial periférica (PFP) após o diagnóstico bucomaxilofacial e após fonoterapia. Material e Métodos: Cinco sujeitos com diagnóstico de PFP participaram da pesquisa. Os participantes foram submetidos a audiometria e, após confirmada a normalidade auditiva, imitanciometria (timpanometria e reflexo estapédico). Os sujeitos foram submetidos a fonoterapia (por, no máximo, três meses) e,posteriormente, realizaram nova imitanciometria, a fim de se comparar os resultados do reflexo estapédico com o primeiro exame. Resultados: Anteriormente à fonoterapia, foi verificada ausência de reflexo estapédico nas frequências de 500, 1.000, 2.000 e 4.000Hz em todos os participantes.Após a fonoterapia, foi verificado retorno do reflexo em umaou mais frequências em quatro pacientes. Conclusões:Possivelmente, a fonoterapia promoveu o retorno da presençade reflexos estapédicos, inicialmente, na frequência de 500Hze se estendendo à frequência de 1.000Hz. A imitanciometria,ao revelar o retorno da função do músculo estapédio, pode fornecer dados ao fonoaudiólogo com relação ao planejamento terapêutico do paciente com PFP.

Objective: To compare the stapedial reflex characteristics inpatients with facial paralysis after bucomaxilofacial diagnosisand phonoaudiological therapy. Material Method: Five peopleparticipated in the study. They were submitted to anaudiometry exam, and after normal hearing confirmation, toan imitanciometry (timpanometry and stapedial reflex).Subsequently to the exams, the subjects were submitted tophonoaudiological therapy, and then submitted to a newimitanciometry to be compared with the first exam results.Results: Previously to the phonoaudiological therapy, it wasverified absence of stapedial reflex in the frequencies 500;1,000; 2,000 and 4,000Hz in all subjects. After thephonoaudiological therapy, it was verified a stapedial reflexreturn in four people. Conclusions: The phonoaudiologicaltherapy possibly promoted the return of normal stapedialreflex physiology, initially in 500Hz frequency, extending to1,000Hz. The imitanciometry, revealing that return, mayprovide important information to the phonoaudiologist relatedto the therapeutic planning of people with facial paralysis.

[Risk factors for the progression of food by oral ingestion of patients with degenerative neurological diseases in monitoring in speech therapy]. / Factores de risco para a progressão da ingestão alimentares por via oral de doentes com doenças neurológicas degenerativas em acompanhamento em terapia de fala.

UNLABELLED: Currently studying the speech voice therapy effectiveness in cases of oropharyngeal dysphagia has been deepened and included the variables that prevent the patient develops treatment. OBJECTIVE: To study the possible risk factors for progression of food intake by mouth during the speech accompanying dysphagia in patients hospitalized with degenerative neurological diseases. METHOD: Retrospective study conducted at the Department of Speech Therapy in a General Hospital from January 2007 to May 2008. Were collected 117 records of patients with oropharyngeal dysphagia, and only 15 (12.8%) were diagnosed with degenerative neurological disease, evolved with complaints of dysphagia and underwent speech therapy. We used myofunctional orofacial and vocal exercises for rehabilitation. We applied Fisher's exact test and nonparametric test Mann-statistical analysis of possible relationship with risk factors, namely clinical events during therapy and respiratory conditions of patients. RESULTS: Study participants were 11 (73.3%) female patients and four (26.7%) males. Ten (66.7%) patients who progressed on the ability of oral intake and had less time in therapy, 11 (73.4%) did not present any problem, two (13.3%) had worsening of symptoms and two (13.3%) had a lowered level of consciousness during the therapeutic process. Ten of 15 patients (66.7%) showed progression in the ability of oral intake according to clinical assessment (range FOIS®), five (33.3%) remained the same conditions prior to therapy and no patient had worsening oral intake. CONCLUSION: The level of consciousness and respiratory complications in this study were associated with poor prognosis for the progression of oral in speech therapy.