Navegando por Palavras-chave "deglutição"
Agora exibindo 1 - 8 de 8
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Achados fonoaudiológicos em pacientes submetidos a anastomose hipoglosso facial(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2003-06-01) Silva, Elisabete C. C. F. [UNIFESP]; Testa, Jose Ricardo Gurgel [UNIFESP]; Fukuda, Yotaka [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Bandeirantes de São Paulo Ciências da Reabilitação Neuro-MotoraThe hypoglossal-facial anastomosis (HFA) have been related in patients with facial nerve lesion where proximal segment more other surgical produceres had been faited or had not been possible success. AIM: The objective of the present research is to verify the evidence of mobility in the phonoarticulate organs, speech function, chew and swallowing in patients sujected to HFA. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: Eight patients with peripheral facial paralysis (PFP) were evaluated and subjected to HFA at UNIFESP/EPM in the period from 1989 to 2000, with 6 females and 2 males, aged between 21 and 71 years with an average of 50 years. Of these, 5 after exeresis of Acoustic Neurinoma, 1 after exeresis of Fibrosarcoma, 1 after a gunshot wound and 1 after idiopathic peripheral facial paralysis of poor evolution. In the phonoaudiological evaluation, the protocol used involved identification data; classification of the facial nerve; treatments carried out; facial symmetry in repose and on voluntary movement; synhinesis of the eyes, mouth, nose and cheeks; phonoarticulate and tongue disorders; changes in chew and of the palate and a questionary concerning the appearence of the respective disturbances. RESULTS: The degree of pos anastomosis and reabilitation ranged to the eyes between II and V and to the mouth between III and V (House & Brakemann, 1985). We came to the conclusion that the recover was satisfactory and important but patients'recover expectation were inferior. There have been noted: articulatory imprecision chewing disfunction, deficit sphincteral function of oral muscles and disphage.
- ItemAcesso aberto (Open Access)Avaliação clínica e videofluoroscópica da deglutição em crianças com paralisia cerebral tetraparética espástica(Academia Brasileira de Neurologia - ABNEURO, 2003-09-01) Furkim, Ana Maria [UNIFESP]; Behlau, Mara [UNIFESP]; Weckx, Luc Louis Maurice [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); CEFAC; HCORCerebral palsy is a condition that may be associated with swallowing disorders, that is, oropharingeal dysphagia. The aim of this study was to characterize and compare the swallowing processes of 32 children with this condition, by clinical and videofluoroscopic evaluation, with special focus on tracheal aspiration detectability. Results show an important compromise of oral phase. The most important findings during the pharyngeal phase were velopharingeal incompetence and residuals on the pharyngeal recesses. Aspiration was more common with liquids, before and after deglutition. On clinical and videofluoroscopic evaluation, cervical hyperextension was the commonest postural abnormality. Videofluoroscopy confirmed the occurrence of aspiration on most of the cases that presented suggestive signs of aspiration during clinical evaluation. We conclude that clinical and videofluoroscopic evaluations are complementary on deglutition evaluation and together may point to the most specific rehabilitation procedure.
- ItemAcesso aberto (Open Access)Avaliação clínica, endoscópica e manométrica da deglutição em pacientes com miastenia grave autoimune adquirida(Academia Brasileira de Neurologia - ABNEURO, 2002-12-01) Oda, Adriana Leico [UNIFESP]; Chiappetta, Ana Lúcia de Magalhães Leal [UNIFESP]; Annes, Marcelo [UNIFESP]; Marchesan, Irene Queiroz; Oliveira, Acary Souza Bulle [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)Dysphagia, or difficulty swallowing, is a common problem following myasthenia gravis (MG) and may lead to aspiration of saliva, food or liquids. We herein present 22 MG patients, with complaint of dysphagia, evaluated by phonoaudiological evaluation, nasofibrolaryngoscopical analysis and manometry of upper esophageal sphincter. The main objective was to evaluate the phases of the swallowing process and anatomical and functional aspects of oropharyngeal musculature. The age of patients varied from 19 to 74 years; being 19 female and 3 male. The main data were: (1) statistically significant relation between the phonoaudiological clinical evaluation and nasofibrolaryngoscopical one; (2) stomatognatical system disorders present in 100%; (3) swallowing and chewing disorders present in 100%, when clinically evaluated, and in 81,8% when evaluated by the nasofibrolaryngoscopy; (4) statistically significant relation between penetration/aspiration and antecedents of pneumonia; (5) stomatognatical muscles very altered, difficulty controlling the bolus, collection of food in the pharynx or larynx and presence of penetration and/or aspiration showed significant correlation with weakness of a pharyngeal muscles. These findings justify the necessity to evaluate clinically the swallowing phases in MG patients, with the main purpose to prevent both aspiration and dehidration from inadequate oral intake.
- ItemAcesso aberto (Open Access)Correlação entre os achados clínicos da deglutição e os achados da tomografia computadorizada de crânio em pacientes com acidente vascular cerebral isquêmico na fase aguda da doença(Academia Brasileira de Neurologia - ABNEURO, 2006-12-01) Barros, Anna Flávia Ferraz; Fábio, Soraia Ramos Cabette; Furkim, Ana Maria [UNIFESP]; CEFAC; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Stroke is one of the main causes of permanent lesions in adults and can provoke global motor sequels, speech and language alterations, and swallowing. During the acute phase, the detection of aspiration risks is essential to prevent lung complications and to allow appropriate therapeutic interventions, making possible precocious oral feeding. In the literature, the correlations between the disturbance of the deglutition and the location of the lesion in patients with stroke are not specific. This way, the objective of the present study was to determine if correlation exists between the location of the vascular lesion and dysphagia in acute ischemic stroke patients. Bedside clinical evaluation of deglutition was made in 27 patients with acute ischemic stroke and the results were compared with the computed tomography findings. In the clinical evaluation, 48% patients were dysphagic and 52% had functional deglutition. In dysphagic patients, 84% had lesion in carotid territory, with 76% in the middle cerebral artery. In patients with functional deglutition, 57% had lesion in the middle cerebral artery and 22% in the posterior cerebral artery. In 50% of the patients with functional deglutition and in 46% of the dysphagics the lesion was in the left hemisphere. In conclusion, the hemispherical location is not associated with the presence or not of dysphagia, however most of the dysphagic patients presented alterations in the carotid territory, especially in the middle cerebral artery.
- ItemAcesso aberto (Open Access)Disfagia orofaríngea na distrofia miotônica: avaliação fonoaudiológica e análise nasofibrolaringoscópica(Academia Brasileira de Neurologia - ABNEURO, 2001-06-01) Chiappetta, Ana Lúcia de Magalhães Leal [UNIFESP]; Oda, Adriana Leico [UNIFESP]; Zanoteli, Edmar [UNIFESP]; Guilherme, Arnaldo [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We herein present twenty myotonic dystrophy of Steinert patients with the main objective to evaluate and classify the oropharyngeal swallowing by the phonoaudiological clinical and nasofibrolaryngoscopical analysis. The age of the patients varied from 12 to 53 years, being 13 male and 7 female. The mean data: (1) statistically significant relation between the phonoaudiological clinical evaluation and nasofibrolaryngoscopical one; (2) stomatognatical system disorders present in 100%; (3) swallowing disorders present in 95%, when clinically evaluated, and in 70% when evaluated by the nasofibrolaryngoscopy; (4) higher difficulty to swallow consistent feed; (5) stomatognatical muscles very altered, pharyngeal phase disorders, cough after swallowing, antecedents of pneumonia and complaints of chewing/swallowing presented statistically significant correlation with severity of the sickness. The analysis were able to evaluate statical and functionally the involved structures in the swallowing, having got to take part of the rotine of attendance to the patients with myotonic dystrophy of Steinert.
- ItemSomente MetadadadosEfeitos da estimulação do fluxo aéreo nasal na deglutição em pacientes com ataxia-telangiectasia(Universidade Federal de São Paulo (UNIFESP), 2014-08-19) Nishinaka, Maria Lucia Tomoko [UNIFESP]; Carvalho, Beatriz Tavares Costa Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Ataxia-Telangiectasia - AT is a rare neuromuscular disease caused by a mutation in the chromosome-encoded 11q22-23 ATM genes. Clinical manifestations included: progressive ataxia, oculocutaneous telangiectasia, ocular apraxia, immunodeficiency, recurrent sinopulmonary infections, increased risk for development of malignancy, hypersensitivity to radiation, dysarthria and dysphagia. Despiste the complexity of clinical manifestations, the patients present a progressive muscle impairment, involving the orofacial and respiratory muscles resulting in significant decline in lung function and worsening of dysphagia in these patients. Speech therapy may help to improve the orofacial functions with improved dysphagia (swallowing disorders) in various degenerative diseases such as Parkinson's, Amyotrophic Lateral Sclerosis, Machado-Joseph disease, Friedreich's ataxia and olivopontocerebellar atrophy. To date there aren?t any speech-language studies that show its effects in patients with AT. Furthermore, our professional experience suggests that speech therapy can help in improving the quality of life of individuals, leading us to the challenge of promoting this scientific study. Objective: This study aims to evaluate the effectiveness of speech therapy adapted for patients with AT, with purpose to improve their respiratory function, and its effects on swallowing-related quality of life after 18 months of treatment. Method: The study was conducted on ten patients: five who had been treated weekly (Group S) and five, monthly (Group M). All underwent speech evaluation and the parent or guardian responded jointly with their children to a quality of life questionnaire for dysphagia SWAL-QOL at baseline and after 18 months of speech therapy adapted for these patients. A NFIP (Peak Nasal Inspiratory Flow), and MIP (maximum inspiratory pressure) were performed at the beginning 0, 6, 12 and 18 months. Results: During treatment the improvement of nasal patency and inspiratory muscle strength was observed over time in both groups, but higher in Group S. After treatment the Group S showed a significant improvement in areas such as swallowing burden, symptoms and mental health, compared to the initial results, resulting in improving the quality of life of these patients. The Group M showed improvement but not significant in any of the areas, however, initially have had a better swallowing-related quality of life compared with Group S. All reported improvement in breathing, swallowing and ease of chewing. Conclusion: We conclude that the speech therapy adapted for patients with Ataxia Telangiectasia was effective in the improvement of oral functions, especially respiration and swallowing, assisting in improving the quality of life.
- ItemAcesso aberto (Open Access)Parâmetros acústicos do som da deglutição normal(Universidade Federal de São Paulo (UNIFESP), 2010-05-26) Silva, Érika Henriques de Araújo Alves da [UNIFESP]; Gonçalves, Maria Inês Rebelo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To describe the acoustic parameters of the sound of the swallow of individuals without complaint and to relate to the acoustic parameters of the swallow (peak of frequency, peak of intensity and duration) with sex, volume and consistency of food. Material and Method: The sample was composed by 118 individuals (58 men and 60 women) with ages between 18 and 39 years (27,29 means age), without complaints with regard to the swallow and absence of former or current history of mechanic or neurological dysphagia, illnesses, traumas and/or surgeries in head and neck area and/or anatomical alterations of the verbal socket that could influence in the functions of speaking and swallowing, besides alteration of skin in the cervical region. It was used a cardiologic auscultation microphone adapted for capitation of the sounds of the swallow, located in the cervical region hardwired to the micron computer. Three swallows of saliva, liquid (water) and paste had been recorded (yoghurt), being the two last ones in the volumes of 1, 3, 5 and 10ml, in the total of 27 swallows for individual. The sounds recorded were analyzed by the software acoustics Audition analysis Adobe version 15.0. Results: The average values of the peak of frequency, peak of intensity and duration of the sound of the swallow in the men were respectively: 509,8191(Hz), -10,1211(dB) and 0,3976(s); the average values of the peak of frequency, peak of intensity and duration of the sound of the swallow in the women were respectively: 468,4373,4373(Hz), -14,0142(dB) and 0,4150(s). There was a significant statistics difference in the parameters peak of intensity of the sound of the swallow that was bigger in the men than in the women; when compared to the consistence, the duration of the sound of the swallow of the liquid was greater that in the paste for the volumes of 3, 5 and 10ml. Sound of the swallow with the tested volumes did not have statistics difference in the correlation of duration. Conclusions: There as not difference between the peaks of frequency and duration of the sound of the swallows of men and women. There was an increase in the peak of intensity of the men compared to the women. Considering the total of the sample, the duration of the sound of the swallow of the liquid was greater that the paste for the volumes of 3, 5 and 10ml. Correlation was not established between the duration of the sound of the swallow and volumes. There was an increase in duration of the sound of swallow with increasing volumes to liquid consistency, except with 10ml.
- ItemAcesso aberto (Open Access)Vídeoendoscopia da deglutição na esclerose lateral amiotrófica(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2013-06-01) D'ottaviano, Fabiana Gonçalez; Linhares Filho, Tarcisio Aguiar; Andrade, Helen Maia Tavares de; Alves, Percilia Cardoso Lopes [UNIFESP]; Rocha, Maria Sheila Guimarães [UNIFESP]; Hospital Santa Marcelina Residência Médica em otorrinolaringologia; clínica Otorhinus; Hospital Santa Marcelina Ambulatório de Doenças Neuromusculares; Hospital Santa Marcelina Residência Médica em Neurologia; Universidade Federal de São Paulo (UNIFESP); Hospital do Câncer A. C. Camargo Motricidade Oral em Oncologia; Hospital Santa Marcelina; Hospital Santa Marcelina programa de residencia médica em neurologiaAmyotrophic lateral sclerosis (ALS) is a progressive degenerative motor neuron disease that adversely affects the muscles responsible for swallowing. OBJECTIVE: To assess the oral preparatory, oral transit and pharyngeal phases of swallowing in ALS patients through endoscopic evaluation. METHOD: This cross-sectional historical cohort study included ALS patients submitted to endoscopic examination. Eleven patients (six males and five females; mean age of 61.7 years) were enrolled in the study from january to december of 2011. RESULTS: All patients had alterations in phases of the swallowing process, but only 72.7% complained of dysphagia. The oral preparatory phase was altered in 63.6% of the subjects; the oral transit and pharyngeal phases were altered in all studied individuals, regardless of food consistency. Laryngeal penetration or tracheal aspiration were seen in 90.9% of the patients during the pharyngeal phase while they were swallowing fluids. CONCLUSION: Even in the absence of complaints, dysphagia is a frequent comorbidity in ALS patients. The oral transit and pharyngeal phases were the most frequently affected. Laryngeal penetration or tracheal aspiration occurred more frequently during the pharyngeal phase while patients were swallowing fluids.