Upper Esophageal Sphincter Opening During Swallow in Stroke Survivors
Abstract
OBJECTIVE: Timely and efficient upper esophageal sphincter (UES) opening may be critical to safe transport of food or liquid to the stomach and to prevent aspiration during the swallow. The purpose of this study was to examine the temporal and biomechanical characteristics of the UES opening in stroke survivors. METHOD: Maximum duration and width of the UES opening were obtained from 15 stroke survivors with aspiration and 15 stroke survivors with no aspiration. The control group was composed of 15 normal subjects undergoing videofluoroscopic swallowing examinations. The videofluoroscopic swallowing examination protocol was as follows: two swallows of 5 ml thin liquid and two swallows of 10 ml thin liquid. Statistical comparisons were made by repeated measurements of analysis of variance, and the significance level was set at P < 0.025. RESULT: The stroke survivors with aspiration, the stroke survivors without aspiration, and the control group differed significantly for duration of UES opening (P < 0.01) but not maximum width of UES opening. CONCLUSION: Prolonged UES opening may be related to prolonged pharyngeal transition of the bolus and slower UES muscle contraction and hyolaryngeal excursion after stroke.
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Reduced UES opening diameter, delayed opening onset, or premature closure shorten UES opening duration and can cause pharyngeal residue, which may enter the upper or lower airway and is a known risk factor for pneumonia and airway obstruction.
“Reduced UES opening diameter, delayed onset of opening, or premature closure attenuate UES opening duration and can result in pharyngeal residue that in turn can enter the upper (laryngeal penetration) or lower (aspiration) airway, which are known risk factors for pneumonia and airway obstruction [23].”
From Upper esophageal sphincter opening segmentation with convolutional recurrent neural networks in high resolution cervical auscultation (2021) · cites this paper as [23]
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Khalifa, Y., Donohue, C., Coyle, J. L., & Sejdic, E. (2021) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2020.3000057 · Cited by 49 · see citing works
- Authors
- Kim, Y., Park, T., Oommen, E., & McCullough, G.
- Affiliations
- Calvin University (US)
- Corresponding author
- Kim, Youngsun
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2015-09
- Volume
- 94
- Issue
- 9
- Pages
- 734-739
- ISSN
- 0894-9115 (ISSN-L)
- OpenAlex
- W2030382553
- Cited by
- 25
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 1
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- upper esophageal sphincter, stroke survivors, dysphagia, aspiration, swallowing biomechanics
- MeSH terms
- Stroke Rehabilitation, Deglutition, Deglutition Disorders, Female, Fluoroscopy, Follow-Up Studies, Humans, Male, Muscle Contraction, Pneumonia, Aspiration, Reference Values, Time Factors, Video Recording, Esophageal Motility Disorders, Treatment Outcome, Survivors, Risk Assessment, Stroke, Esophageal Sphincter, Upper
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