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[Dysphagia] Reduced bolus driving force
Yep. The Masako improves anterior movement of the posterior pharyngeal wall, which helps to compensate for poor tongue base retraction. I believe that because your tongue is being held still (in the anterior position), it can not do any of the work in the swallow. Therefore the posterior pharyngeal wall muscles must work harder & consequently get stronger? Maybe just my own theory.
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of Brawley, Mary
Sent: Monday, April 04, 2005 8:09 AM
To: AnnaMaria Koo; dysphagia@b9.com; debinski@bigpond.net.au
Subject: RE: [Dysphagia] Reduced bolus driving force
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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