Intraorale Druckmessungen bei dysphagischen ALS-Patienten im Vergleich zu einem Normkollektiv

Intra-oral maximal suction pressure indicates dysphagia in patients with amyotrophic lateral sclerosis

by Deike Dr. Dr. Böning
Doctoral thesis
Date of Examination:2016-02-03
Date of issue:2016-01-18
Advisor:PD Dr. Arno Olthoff
Referee:Prof. Dr. Dr. Wilfried Engelke
Referee:Prof. Dr. Margarete Schön
Persistent Address: http://dx.doi.org/10.53846/goediss-5463

 

 

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Abstract

English

Apart from mechanical positive pressures (e.g. maximal tongue strength) negative atmospheric pressure gradients are given as intra-oral forces. Up to date clinical relevance of these forces is still indistinct. The aim of the present study is to give an insight into the intra-oral atmospheric maximal pressure of a reference group in contrast to dysphagic patients with amyotrophic lateral sclerosis (ALS). Therefore 20 healthy volunteers and 10 patients suffering from ALS underwent a flexible endoscopic evaluation of swallowing (FEES), a manometric measurement of the maximal intra-oral atmospheric pressure generated by suction as well as of the prevalent pressure during swallowing. Additionally the sydney swallowing questionnaire (SSQ) was completed by all participants to score the self-rated extent of dysphagia. All participants presented negative intra-oral pressure during swallowing and no significant difference was seen between ALS patients and healthy volunteers. Regarding maximal suction the comparison of both groups showed significant lower maximal atmospheric pressures in ALS patients (p<0.001). Subtracting the negative intra-oral pressure during swallowing the maximal negative pressure seems to represent a “functional reserve” that ensures normal swallowing. Significant correlations of maximal pressure and “functional reserve” versus SSQ-score were seen (r1=-0.73; r2=-0.65). As the oral cavity is an easy accessible compartment of the upper digestive tract, future manometric measurement could be proved as technique for screening, diagnostic and therapeutic control or biofeedback in ALS and other dysphagic patients.
Keywords: intra-oral pressure; swallowing; dysphagia; functional reserve; manometry; suction; amyotrophic lateral sclerosis
Schlagwörter: intraoraler Sog; Schluckvorgang; Dysphagie; funktionelle Reserve; Manometrie; Saugvorgang; amyotrophe Lateralsklerose
 
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