[Dysphagia] Reduced bolus driving force

[MBrawley at mcw.edu (Brawley, Mary)]

The exercise you describe sounds like the Masako. It is my understanding
that the Masako maneuver increases anterior movement of the posterior
pharyngeal wall.

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On
Behalf Of AnnaMaria Koo
Sent: Monday, April 04, 2005 8:45 AM
To: dysphagia@b9.com; debinski@bigpond.net.au
Subject: Re: [Dysphagia] Reduced bolus driving force

I don't know what the abbreviations THR and NOT GA stand for, so I can't
comment on the possible causes.  Have you considered tongue
strengthening exercises to increase tongue base retraction? One example
is having a patient hold their tongue in between their front teeth and
swallow. Holding the tongue in place provides resistance to the base of
the tongue and encourages increased strength.

Anna Maria Koo
Speech-Language Pathologist
Specialized Geriatric Services & CORP
SJHC, Parkwood Site
ext.42205

>>> Henry Debinski <debinski@bigpond.net.au> 04/04/05 9:08 AM >>>

An 82 year old prev fit and well female presented with dysphagia to 
solids 10 days post THR which was performed under spinal NOT GA..VF 
shows oral and pharyngeal phases which are WNL for liquids and semi 
solds. When she attempts solids, the oral phase is WNL however base of

tongue to posterior pharyngeal wall contact appears reduced  with a 
subsequent profoundly weakened bolues driving force. Epiglottic 
retraction appears ok. The bolus remains mostly in the oropharynx 
though there is no laryngeal penetration or aspiration. There are no 
other neurological signs.  Interestingly she does comment that her 
reflux is significantly worse since surgery as well. Any thoughts on 
the cause and how to address this problem Currently she is having a 
vitamized diet and thin liquids. Aviva Melbourne Australia
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