Dissertação
Análise da fase oral da deglutição em indivíduos com doença pulmonar obstrutiva crônica
Fecha
2018-07-09Autor
Tomasi, Lidia Lis
Institución
Resumen
In addition to effects on quality of life of patients and functional ventilatory
impairment, Chronic Obstructive Pulmonary Disease (COPD) produces changes
in the swallowing function. The oral phase of swallowing is voluntary and
corresponds to the act of positioning the bolus in the mouth and carrying out the
posterior projection of it to the oropharynx. The analysis of the temporal
quantitative variable oral transit time, including its definitions, markers of
beginning and ending, swallowing of different consistencies and volumes of food
are of extreme importance for the knowledge and regulation of the times in
different populations and for the aid in the treatment and therapeutic management
of swallowing dysfunctions. The aim of the present study was to analyze the oral
phase of swallowing in individuals with COPD. This is a cross-sectional,
descriptive and quantitative study involving patients with a medical and
spirometric diagnosis of COPD, accompanied by the pulmonary rehabilitation
program of the Hospital Universitário de Santa Maria, RS. The patients were
submitted to Videofluoroscopy of deglutition (VFD) to quantitatively characterize
the swallowing biomechanics, and the dental evaluation for oral health and dental
condition analysis. The analysis of VFD exams was performed by three blinded
judges who analyzed the variables oral transit time (OTT) and total oral transit
time (TOTT), pre-swallow posterior spill, delayed initiation pharyngeal reflex and
pharyngeal residue by means of software. The statistical tests were: Intraclass
correlation coefficient, t test for equality of means, Wilcoxon test and Student t
test. We studied 25 patients (15 men and 10 women), with a mean age of 65
years (41 to 77 years). It was observed OTT of 2.09s for liquid consistency and
1.61s for pasty, and TOTT of 2.34s and 1.84s for liquid and pasty consistencies,
respectively. The OTTs are altered and larger as the severity of COPD increases.
For both consistencies, the delayed initiation pharyngeal reflex occurred in higher
anatomical regions. There was absence of pre-swallow posterior spill and
pharyngeal residue in most patients. Most of the analyzed individuals had poor
dental condition. It was concluded that there were alterations in the oral phase of
swallowing of COPD subjects, with change in the quantitative variable OTT for the liquid and pasty consistencies