• Title/Summary/Keyword: swallowing

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Palatal obturator restoration of a cleft palate patient with velopharyngeal insufficiency: a clinical report (구개인두 기능부전을 갖는 구개열 환자에서 폐쇄장치를 이용한 보철 치료 증례)

  • Heo, Yu-Ri;Kim, Jong-Wook;Lee, Gyeong-Je;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.353-360
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    • 2013
  • Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.

The study on development of easily chewable and swallowable foods for elderly

  • Kim, Soojeong;Joo, Nami
    • Nutrition Research and Practice
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    • v.9 no.4
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    • pp.420-424
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    • 2015
  • BACKGROUND/OBJECTS: When the functions involved in the ingestion of food occurs failure, not only loss of enjoyment of eating, it will be faced with protein-energy malnutrition. Dysmasesis and difficulty of swallowing occurs in various diseases, but it may be a major cause of aging, and elderly people with authoring and dysmasesis and difficulty of swallowing in the aging society is expected to increase rapidly. SUBJECTS/METHODS: In this study, we carried out a survey targeting nutritionists who work in elderly care facilities, and examined characteristics of offering of foods for elderly and the degree of demand of development of easily chewable and swallowable foods for the elderly who can crush foods and take that by their own tongues, and sometimes have difficulty in drinking water and tea. RESULTS: In elderly care facilities, it was found to provide a finely chopped food or ground food that was ground with water in a blender for elderly with dysmasesis. Elderly satisfaction of provided foods is appeared overall low. Results of investigating the applicability of foods for elderly and the reflection will of menus, were showed the highest response rate in a gelification method in molecular gastronomic science technics, and results of investigating the frequent food of the elderly; representative menu of beef, pork, white fish, anchovies and spinach, were showed Korean barbecue beef, hot pepper paste stir fried pork, pan fried white fish, stir fried anchovy, seasoned spinach were the highest offer frequency. CONCLUSIONS: This study will provide the fundamentals of the development of easily chewable and swallowable foods, gelification, for the elderly. The study will also illustrate that, in the elderly, food undergone gelification will reduce the risk of swallowing down to the wrong pipe and improve overall food preference.

ELECTOROGLOTTOGRAPH IN NORMAL ADULT ; PRELIMINARY STUDY FOR ELECTROGLOTTOGRAPHIC STUDY OF SWALLOING DISORDER (정상 성인에서의 전기성문파형 검사 ; 연하장애 환자의 전기성문파형 검사를 위한 예비연구)

  • Kim, Young-Bin;Lee, Ju-Kyung;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O;Im, Ik-Jae;Kim, Hyun-Ki;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.5
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    • pp.437-446
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    • 2008
  • Electroglottography (EGG) is a simple and non-invasive technique for analyzing the vibratory patterns of the vocal folds by detecting impedance changes across the larynx. An abnormal electroglottogram is shown in patients who have a dysphagia associated with neuromuscular disorder. Electroglottography offers reliable informations for diagnosis of swallowing disorder and gives quantitative datas. The purpose of this study is to provide the normal value of electroglottography in normal adults. We took electroglottograms of 80 adults who have no problem in swallowing and utterance. EGG data were analyzed to find out the value of Pitch, Jitter and Closed quotient with a commercially available software. There were significant differences between a usual voice and loud voice in 3 measures on the EGG signalmean pitch, Avg. jitter, mean quotient. To get a proper electroglottography, phonation of a usual voice was better than a loud voice. Four measurements- S.D pitch, Avg. Jitter, Mean closed quotient, S.D closed quotient- were independent of sex for adult. Three measurements- Mean pitch, S.D pitch, Mean closed quotient - were independent of age for adult aged twenties to fifties. The Avg. Jitter of twenties appeared to be lower than those of forties and fifties. The S.D closed quotient of twenties appeared to be lower than those of thirties, forties and fifties.

A CINEFLUOROSCOPIC STUDY OF OROPHARYNGEAL MOVEMENT OF THE CLASS III MALOCCLUSION PATIENTS DURING SWALLOWING (CINEFLUOROSCOPY를 이용한 III급 부정교합 환자의 연하시 구강인두의 운동에 관한 연구)

  • Ryu, Dong-Soo;Jin, Ik-Jae;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.17 no.1
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    • pp.119-134
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    • 1987
  • This study was undertaken to find out oropharyngeal movement of the class III malocclusion patients during swallowing by using the cinefluoroscopic method. The experimental group was composed of fifteen male adults with class III malocclusion whose mean age was 24.4 yrs. The control group was composed of fifteen male adults with normal occlusion whose mean age was 24.8 yrs. The results were as follows: 1. The horizontal position of the tongue tip was more anterior in the class III malocclusion group than in the normal group through all stages. 2. The tongue level was lower in the class III malocclusion group than in the normal group during stage 1, stage 3, and stage 4. 3. The horizontal position of the hyoid bone was more anterior in the class III malocclusion group than in the normal group during stage 1 only. 4. The tip of the soft palate was lower in the class III malocclusion group than in the normal group during stage 1 only, and there was no significant difference in the velar movement between the class III malocclusion group and the normal group during swallowing. 5. There was a significant difference in the interincisal distance, but no significant difference in the intermolar distance between the class III malocclusion group and the normal group through all stages. 6. Among 4 stages of each group, there was a significant difference in the movements of the dorsum of the tongue, the hyoid bone, and the soft palates And there was a significant difference in the movement .of the tongue tip of the normal group, but no significant difference in the movement of the tongue tip of the class III malocclusion group.

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Case of making maxillary palatal augmentation complete denture for patient with dysphagia after partial glossectomy (부분 혀 절제술로 인해 연하 장애가 있는 환자에서 상악 구개 증대 총의치 제작 증례)

  • Kim, Hyung-Seok;Park, Ji-Young;Yim, Sun-Young;Heo, Yu-Ri;Son, Mee-Kyoung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.239-245
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    • 2018
  • If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.

Acoustic parameter delta of an aspirated voice in stroke patients (뇌졸중 환자 대상 흡인 음성의 음향변수 변동)

  • Kang, Young Ae;Jee, Sung Ju;Koo, Bon Seok;Jo, Cheolwoo
    • Phonetics and Speech Sciences
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    • v.9 no.3
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    • pp.85-91
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    • 2017
  • The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

Clinical Review about Dysphagia associated with Acute Ischemic Stroke (급성 허혈성 뇌졸중에 수반된 연하장애에 관한 임상적 고찰)

  • 한명아;김동웅
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.42-50
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    • 2001
  • Objectives : Dysphagia is common and severe problems of acute stroke determining the prognosis of stroke only second to mental change, and results in secondary fatal complications such as aspiration pneumonia, malnutrition, dehydration, etc. Therefore, we were to investigate the clinical characteristics of dysphagia accompanied by acute ischemic stroke. Methods : We selected subjects through clinical notes retrospectively, whose main problems included dysphagia resulted from acute stroke within 72 hours from onset who were admitted to the Internal Medicine Department of Wonkwang Oriental Medicine Hospital from Jan. 2000 to Apr. 2001. We assessed the severity of dysphagia from admission to discharge using a staging method : stage 0 is normal without dysphagia, stage 1 is nearly normal except for intermittent dysphagia, stage 2 is compensated abnormal swallowing requiring adjusted diets or delayed feeding time, stage 3 is uncompensated abnormal swallowing resulted in weight loss down to 10% of initial and daily aspiration, coughing, and vomiting, stage 4 is uncompensated abnormal swallowing resulting in weight loss beyond 10% and recommended for non-oral feeding, and stage 5 is 100% non-oral feeding by L-tube, or gastrostomy or NPO state. Results : Dysphagia was improved statistically significantly from the mean stage of $3.6{\pm}0.29$ on admission to $1.88{\pm}0.32$ on discharge (P<0.05). On average $7.1{\pm}1.48$ days were required for improving more than one stage level. As patients were older and the stage of dysphagia was worse on admission, severity of dysphagia was more difficult to improve (correlation coefficiency was 0.55 and 0.77 respectively, P<0.05). Aspiration pneumonia was complicated in 13 patients of the total 25 at mean dysphagia stage of $3.36{\pm}0.37$. However, any specific values such as lesion size, lesion site, sex, age, past history and NIH Stroke Scale on admission did not affect it (P>0.05). Conclusion : Clinical course of dysphagia was determined about I week from the onset. Aspiration pneumonia was mainly complicated during oral feeding periods. If there were no improvement of dysphagia over 2-3 weeks, then non-oral feeding such as Levin tube or gastrostomy must be considered.

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Dental Status and Oral Function in Some Long-term Care Elderly Patients (일부 노인장기요양환자의 구강실태 및 구강기능)

  • Lee, Yun-Hui;Yoon, Hee-Jung;Lee, Hee-Keung;Lee, Sung-Kook
    • Korean Journal of Health Education and Promotion
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    • v.25 no.4
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    • pp.55-65
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    • 2008
  • Objective: This study aims to investigate the relationship between dental status and oral function by analyzing those in some long-term care elderly patients. Methods: It performed oral examination and 4 oromotor function examinations such as repeated swallowing function, correct pronunciation function, saliva secretion rate and maximum mouth opening to 91 elderly patents aged 65 and older in the municipal geriatric hospital located in Cheonan. Results: Dental status of patients such as the number of dental caries, treated teeth, retained teeth and function teeth were better in mobile elderly patients than in immobile elderly patients. Attachment rate of dental plaque and the number of teeth being extracted were more in mobile patients than in immobile patients. More retained teeth, the number of function teeth and dental caries and the score in pronunciation status test were significantly higher. With more function teeth, the score in pronunciation status test was significantly higher. As saliva secretion rate is higher, repeated swallowing function was significantly better. repeated swallowing function rate is higher pronunciation status was significantly better. Conclusions: With the results of this study, it was found that among long-term care elderly patients, oral function was worse in immobile patients than in mobile patients. Therefore, it may be necessary to plan and perform an oral function improvement program preferentially for elderly patients requiring long-term care.

Evaluation of Sex and Age Factors Contributing to the Diagnosis of Oral Frailty in Community-Dwelling Older Adults

  • Eun-Ha Jung;Sun-Young Han
    • Journal of dental hygiene science
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    • v.23 no.4
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    • pp.378-388
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    • 2023
  • Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.