Multi-disciplinary clinical protocol for the diagnosis of bulbar amyotrophic lateral sclerosis

Autor: Carmela Di Luciano, Agostino Serra, I. Chiaramonte, Marco Bonfiglio, Rita Chiaramonte
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Sound Spectrography
Audiology
Severity of Illness Index
Articulatory phonetics
Speech Acoustics
03 medical and health sciences
Dysarthria
Otolaryngology
0302 clinical medicine
Swallowing
Clinical Protocols
Tongue
otorhinolaryngologic diseases
medicine
Internal Medicine
Fiber Optic Technology
Humans
Phonation
Amyotrophic lateral sclerosis
030223 otorhinolaryngology
Electroglottograph
Neurologic Examination
Patient Care Team
business.industry
Electrodiagnosis
Amyotrophic Lateral Sclerosis
General Medicine
Middle Aged
medicine.disease
Dysphonia
Respiration Disorders
Formant
medicine.anatomical_structure
Early Diagnosis
Otorhinolaryngology
Neurology
Vocal folds
Disease Progression
Pharyngeal Muscles
Female
Interdisciplinary Communication
Esophagoscopy
medicine.symptom
business
Deglutition Disorders
030217 neurology & neurosurgery
Zdroj: Acta otorrinolaringologica espanola. 70(1)
ISSN: 2173-5735
Popis: Introduction and objectives The objective of this study was to examine the role of different specialists in the diagnosis of amyotrophic lateral sclerosis (ALS), to understand changes in verbal expression and phonation, respiratory dynamics and swallowing that occurred rapidly over a short period of time. Materials and methods 22 patients with bulbar ALS were submitted for voice assessment, ENT evaluation, Multi-Dimensional Voice Program (MDVP), spectrogram, electroglottography, fiberoptic endoscopic evaluation of swallowing. Results In the early stage of the disease, the oral tract and velopharyngeal port were involved. Three months after the initial symptoms, most of the patients presented hoarseness, breathy voice, dysarthria, pitch modulation problems and difficulties in pronunciation of explosive, velar and lingual consonants. Values of MDVP were altered. Spectrogram showed an additional formant, due to nasal resonance. Electroglottography showed periodic oscillation of the vocal folds only during short vocal cycle. Swallowing was characterized by weakness and incoordination of oro-pharyngeal muscles with penetration or aspiration. Conclusions A specific multidisciplinary clinical protocol was designed to report vocal parameters and swallowing disorders that changed more quickly in bulbar ALS patients. Furthermore, the patients were stratified according to involvement of pharyngeal structures, and severity index.
Databáze: OpenAIRE
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