A Large Cohort Analysis of Epiglottic Phenotypes and Pharyngeal Residue.
| Autor: | Kravietz A; Department of Otolaryngology/Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA., Crosby T; Department of Otolaryngology/Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA., Yang J; New York University Grossman School of Medicine, New York, NY, USA., Balou S; New York University Grossman School of Medicine, New York, NY, USA., Dion GR; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Logan A; Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, TX, USA., Amin MR; Department of Otolaryngology/Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2024 Apr; Vol. 133 (4), pp. 375-383. Date of Electronic Publication: 2024 Jan 10. |
| DOI: | 10.1177/00034894231218892 |
| Abstrakt: | Objective: To describe the phenotypic characteristics of the epiglottis at rest and their impact on vallecular residue. Methods: Videofluoroscopic studies (VFSS) were pooled from 2 Laryngology practices, and Image J was used to measure epiglottic anatomic features at rest. Studies were rated by the MBSImp and presence of vallecular residue following swallow of thin and puree boluses. A conditional inference tree analysis was performed to isolate which epiglottic parameters were risk factors for presence of vallecular reside followed by logistic regression. Results: The majority of patients had a normal shaped epiglottis, followed by omega shape. The mean angle of the epiglottis from the hyoid was approximately 90°. Only abnormal epiglottic movement was associated with increased risk of residue for thin boluses (OR 35.09, CI 10.93-158.66, P < .001). However, in those with normal epiglottic movement, age >70 years old was associated with increased risk of residue (OR 3.98, CI 1.73-9.23, P = .001). For puree boluses, a normal or omega shaped epiglottis was associated with residue (OR 5.19, CI 2.41-11.51, P < .001), and this relationship was further modulated by increased distance of the epiglottic tip from the posterior pharyngeal wall. No other anatomic features of the resting epiglottis were associated with residue. Comorbidities potentially affecting swallow were infrequent in the cohort and were not associated with residue. Conclusion: Abnormal epiglottic movement is associated with aspiration, and in this study we find that abnormal epiglottic movement increases the risk of vallecular residue and that older age is a risk factor for residue. The resting properties of the epiglottis do not appear to be associated with abnormal epiglottic movement or residue. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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