Ultrasound And Videofluoroscopic Imaging In Oral-pharyng

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Abstract

We are using both ultrasound and videofluorography to examine effects of disease and status of oral motor function on the following conditions: stroke, postpolio syndrome, cystinosis, sydenham's chorea, and Sjogren's disease. Patients who were seen at the NIH for baseline studies from two to fifteen years after their initial examination are being followed to determine the course of change in these functions. Videofluorographic and ultrasound swallowing studies are administered along with complete oral sensory motor function examinations. Data on corticobasal degeneration and apraxia of swallowing have been analyzed. We completed a study to determine the kinematic strategies used during randomized discrete and sequential swallows on 30 subjects age 20 to 79 years. Significant differences were revealed for these two tasks relative to age, gender and movement of the hyoid bone in support of a theory of motor performance that suggests that the Deglutitive motor system is more flexible than previously known. A subset of patients with Cystinosis who were seen in the late 1980's and 1900's are being re-evaluated for the effects of cystagon and kidney transplantation on swallowing and oral motor function. To date there have been 50 returning subjects. Initial inspection of the data from these subjects indicates that older subjects with cystinosis and those with multiple medical conditions such as diabetes, hypothyroidism and elevated blood pressure appear to be at greater risk of oropharyngeal and esophageal dysphagia. New signs of swallowing difficulty are also appearing in post polio patients. These continuing studies are pointing to a progression of swallowing difficulties that place patients with various neuromotor conditions at risk for aspiration.