Dysphagia Grand Rounds 3

The third Dysphagia Grand Rounds (DGR 3) research article we will be reviewing, in March 2017, is posted below. This study discusses the effects of surface electrical stimulation on the position of the hyoid and larynx as well as on swallowing, in participants with chronic pharyngeal dysphagia. The webinar discussing this article will release on March 31st, 2017. Please read the journal article below before watching the DGR 3 webinar to maximize your learning experience. 

Article
Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia
Authors: Christy L. Ludlow, Ianessa Humbert, Keith Saxon, Christopher Poletto, Barbara Sonies, and Lisa Crujido
Journal: Dysphagia. 2007; 22(1):1-10

Download DGR 3 article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1790908/

Download DGR 3 webinar here: http://dysphagiagrandrounds.yondo.com/playlist/dgr-3-march-2017/208

Abstract
We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation 1) lowered the hyoid bone and/or larynx when applied at rest, and 2) increased aspiration, penetration or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior (s-i) and anterior-posterior (a-p) dimensions and the subglottic air column (s-i) position while stimulation was on and off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists blinded to condition, tallied the frequency of aspiration, penetration, pooling and esophageal entry from videofluorographic recordings of swallows. Only significant (p=0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p=0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p= 0.006). Stimulation may have acted to resist patients’ hyoid elevation during swallowing.