Two-dimensional kinetic analyses of swallowing using videofluorographic images of Dysphagia patients

Abstract

[Purpose] This studied examine the two-dimensional kinesis of swallowing by patients with dysphagia, based on the movements of contrast material using videofluorography, aiming to design curative programs for aspiration. Videofluorographic two-dimensional examinations of ten patients with aspiration, and another ten without aspiration were used for this study. [Methods] We converted the video record into static images and plotted hyoid bone and laryngeal kinesis on graphs, using two-dimensional image analysis software. Then, we conducted analyses of the trajectory patterns of the hyoid bone and the larynx, and pharyngeal transit time of the contrast material. [Results] Our two-dimensional method revealed significant differences between the two subject groups in maximal forward travel of the hyoid bone, maximal elevation of the larynx, and pharyngeal transit time. [Conclusion] Our findings suggest that aspiration may be caused by a weak pharyngeal contraction and weakened suprahyoid and infrahyoid muscles resulting in inferior kinesis of the epiglottis, and insufficient closure of the laryngeal introitus. For the treatment of aspiration, we believe the application of kinesiotherapy, electric stimulation therapy and replacement therapy should be clinically effective.