Videofluoroscopy of swallowing abnormalities in 22 symptomatic patients after cardiovascular surgery.
OBJECTIVE
The aim of this study was to evaluate the types of swallowing abnormalities that occur in symptomatic patients who have undergone cardiovascular surgery.


METHODS
From 1994 to 2001, 22 patients (17 males and five females; age range, 4-89 years; mean age, 64 years) who had swallowing abnormalities after cardiovascular surgery were referred for a videofluoroscopic swallowing study. Each study was analyzed for functional abnormalities of the tongue, soft palate, epiglottis, hyoid and larynx, pharynx, upper esophageal sphincter, and esophagus. Also, the performance of transesophageal echocardiography, long-term intubation, or both was noted.


RESULTS
Swallowing abnormalities were present in 18 patients (81.8%) (range, one to eight functional abnormalities; mean, 3.9 functional abnormalities). The distribution of abnormalities across the functional units statistically significantly deviated (chi(2) = 14.4; df = 6; p = 0.025) from uniform distribution, with abnormalities most commonly involving the hyoid and larynx (13 patients [59.1%]) and the pharynx (10 patients [45.5%]). Aspiration was found in 13 patients (59.1%) (predeglutitive, n = 1; intradeglutitive, n = 4; postdeglutitive, n = 3; and mixed, n = 5). In the 14 patients (63.6%) who underwent transesophageal echocardiography, long-term intubation, or both, we frequently found incomplete tilting of the epiglottis, pharyngeal weakness, and postdeglutitive aspiration.


CONCLUSIONS
Most patients with swallowing problems after cardiovascular surgery present with multiple abnormalities that most commonly affect the hyoid and larynx and the pharynx and result predominantly in intra- or postdeglutitive aspiration. The performance of transesophageal echocardiography and long-term intubation may influence the types of swallowing abnormalities.
Partik
Bernhard L
BL
Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Scharitzer
Martina
M
Schueller
Gerd
G
Voracek
Martin
M
Schima
Wolfgang
W
Schober
Ewald
E
Mueller
Michael R
MR
Leung
Ann N
AN
Denk
Doris-Maria
DM
Pokieser
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D014741:Video Recording