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KMID : 1024720200100020062
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Geriatric Rehabilitation
2020 Volume.10 No. 2 p.62 ~ p.69
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Clinical Value of Pharyngeal Width for Prediction of Laryngeal Penetration and Aspiration in Elderly People
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Song Ji-Min
Kang Won-Il
Chung Jane
Jung Kwang-Ik
Yoo Woo-Kyoung
Ohn Suk-Hoon
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Abstract
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Objective: Patients with laryngeal penetration are more likely to develop pneumonia than those who can swallow normally. Pharyngeal width is emerging as a predictor of laryngeal aspiration. We investigated whether pharyngeal width was correlated with the severity of dysphagia and whether it could be a tool to predict not only aspiration but also penetration risk.
Methods: This study retrospectively analyzed pharyngeal width at rest based on lateral neck roentgenograms of 80 elderly people complaining of dysphagia caused by only aging and 80 age-matched controls. The optimal cut-off point for predicting penetration and aspiration was determined by receiver operating characteristic curve analysis of the pharyngeal width.
Results: The grasp power of the dysphagia group was lower than that of the control group (p < 0.05). The pharyngeal width of the dysphagia group was larger than that of the control group (p < 0.05) and was associated with penetration-aspiration scale (PAS) and dysphagia outcome and severity scale (DOSS) scores (p < 0.05). The optimal cut-off of the pharyngeal widths were 16.4 mm (area under the curve [AUC] = 0.753, 95% CI = 0.586?0.919, sensitivity = 65.2%, specificity = 71.4%) for penetration and 18.4 mm (AUC = 0.80, 95% CI = 0.702?0.898, sensitivity = 75.9%, specificity = 74.5%) for aspiration.
Conclusion: Sarcopenic changes in pharyngeal muscle tissue result in larger pharyngeal width, which could be a potential cause of dysphagia. The pharyngeal width may be a new indicator for predicting not only aspiration but also penetration in elderly individuals.
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KEYWORD
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Aged, Deglutition disorder, Laryngeal aspiration, Laryngeal penetration, Pharynx
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