Introduction
Dysphagia after stroke is a common and disabling condition that can cause significant clinical complications, such as aspiration pneumonia and malnutrition. A videofluoroscopic swallowing study (VFSS) with or without endoscopy is a gold standard for evaluating dysphagia. In addition, Transcutaneous laryngeal ultrasonography (TLUS) can be applied to evaluate various laryngeal structures. We evaluated vocal cord movement and compared the VFSS grade with incompletion in vocal cord closure presented by angle degree in hemiplegic stroke patients with dysphagia.
Materials and methods
Six hemiplegic stroke patients with dysphagia were recruited. VFSS and TLUS were conducted with the consent of the patients. VFSS was done for all patients, and for the TLUS, patients lied on their back with neck extension and the ultrasound probe was applied on the centerline of the the thyroid cartilage to find the vocal cords. The movement of the vocal cords was observed while the patient made an 'Ah' sound. We checked the vocal cord paralysis and captured the moment of maximal adduction to midline of them and the angle from the center line was measured.
Results
Five men and one woman were enrolled (age: 74.17±8.97 years old, 3 infarction and 3 hemorrhagic stroke, 3 left and 3 right hemiplegia). Two patients were grade 8 in fluid 2 ml with 25.03⁰±5.55 of the difference between normal side and hemi-side vocal cord adduction angle, and 4 patients were grade 5 in fluid 5 ml with 8.66⁰±8.88 of it. So patients with grade 8 in fluid 2 ml were greater difference in vocal cord adduction angle than that in patients with grade 5 in fluid 5 ml in VFSS.
Conclusion
TLUS could be the additional evaluation tool to check the adduction movement of the vocal cords and then might be expected the severity of the dysphagia.
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