[Dysphagia] Chemical senses and swallowing

[eripley at yahoo.com (Irene Campbell-Taylor)]

A couple of interesting articles:
            A Randomized Trial of Olfactory Stimulation Using Black Pepper Oil in Older People with Swallowing Dysfunction Journal of the American Geriatrics Society
Online Early

      Takae Ebihara, MD, PhD*, Satoru Ebihara, MD, PhD*, Masahiro Maruyama, MD*, Mitsuru Kobayashi, BS, Azusa Itou, BS?, Hiroyuki Arai, MD, PhD, and Hidetada Sasaki, MD, PhD*
      OBJECTIVES: To determine the effect of olfactory stimulation with volatile black pepper oil (BPO) on risk factors for pneumonia.
  DESIGN: A 1-month randomized, controlled study.
  SETTING: Nursing homes in Japan that serve as long-term care facilities for older residents who are physically handicapped, mainly because of cerebrovascular disease.
  PARTICIPANTS: One hundred five poststroke residents.
  MEASUREMENTS: Latency of the swallowing reflex (LTSR), the number of swallowing movements, serum substance P (SP), and regional cerebral blood flow (rCBF).
  RESULTS: Nasal inhalation of BPO for 1 minute shortened LTSR, compared with that of lavender oil and distilled water (P<.03). Compared with the period before the study, the 1-month intervention using BPO improved LTSR with an increase of serum SP (P<.01). The number of swallowing movements for 1 minute during the nasal inhalation of BPO increased (P<.001). Multiple comparisons showed a poststudy increase in rCBF within the insular cortex (P<.001). Compared with the prestudy rCBF, BPO intervention increased rCBF in the right orbitofrontal and left insular cortex (P<.001).
  CONCLUSION: Inhalation of BPO, which can activate the insular or orbitofrontal cortex, resulting in improvement of the reflexive swallowing movement, might benefit older poststroke patients with dysphagia regardless of their level of consciousness or physical and mental status.
       

            Effects of menthol on the triggering of the swallowing reflex in elderly patients with dysphagia
   British Journal of Clinical Pharmacology
Volume 62 Page 369  - September 2006
      Takae Ebihara, Satoru Ebihara, Aya Watando, Tatsuma Okazaki, Masanori Asada, Takashi Ohrui, Mutsuo Yamaya & Hiroyuki Arai
      Aims
  To investigate the effect of menthol on swallowing reflex sensitivity in elderly patients with dysphagia.
  Methods and results
  The swallowing reflex sensitivity of institutionalized elderly patients was evaluated as a latent time of swallowing reflex (LTSR), induced by the injection of 1 ml solution into the pharynx. LTSR was significantly shortened in a concentration-dependent manner, from 13.8 s [95% confidence interval (CI) 11.1, 16.5] by distilled water to 9.4 s (95% CI 7.1. 11.8) by 10 2m menthol.
  Conclusion
  Using menthol with elderly patients with dysphagia may improve the sensitivity of their swallowing reflex, resulting in prevention of aspiration pneumonia.
       

   


Dr I Campbell-Taylor
Clinical Neuroscientist
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