New Swallowing Method to Improve Pharyngeal Passage of a Bolus by Creating Negative Pressure in the Esophagus-Vacuum Swallowing.
Kenjiro Kunieda, Saori Kubo, Ichiro Fujishima
PMID 29194048WHAT IT FOUND
A man with severe swallowing problems after a stroke found that forcefully contracting abdominal muscles while elevating shoulders helped swallow.
Tests showed bolus sucked into esophagus by negative pressure despite weak pharynx. His oral intake improved, but a case report cannot show it works.
Key findings
01The patient reported easier swallowing when forcefully contracting abdominal muscles while elevating shoulders.
02Videofluoroscopy and manometry showed the bolus was sucked into the esophagus by negative pressure despite weak pharyngeal contraction.
03The authors state it is unclear whether this method would be effective in other patients with similar etiologies or other types of dysphagia.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The report describes only this patient. It cannot show that the method works for others. He also received balloon dilatation, Shaker exercise, breathing training, lingual resistance exercise, self-administered balloon dilatation, and direct swallowing training. The paper cannot show which component helped. The patient had a right medullary lateral infarction involving the nucleus ambiguus. The findings may not apply to other stroke patterns or causes of dysphagia. The authors say it is unclear whether the method would be effective in other patients with similar etiologies or other types of dysphagia. The authors say long-term effects on the esophagus are unclear. The authors note others may need to be attentive to aspiration risk from uncoordinated breathing and swallowing.
Declared interests
The supplied text does not report funding or conflicts of interest.
The easy way to misread this
Do not read this case report as proof that vacuum swallowing is an effective treatment for dysphagia. The patient also received balloon dilatation, Shaker exercise, breathing training, lingual resistance exercise, self-administered balloon dilatation, and direct swallowing training, and the contribution of any single component cannot be separated.