Physiological characteristics of dysphagia following thermal burn injury

Rumbach, Anna F., Ward, Elizabeth C., Cornwell, Petrea L., Bassett, Lynell V. and Muller, Michael J. (2012) Physiological characteristics of dysphagia following thermal burn injury. Dysphagia, 27 3: 370-383. doi:10.1007/s00455-011-9376-7

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Author Rumbach, Anna F.
Ward, Elizabeth C.
Cornwell, Petrea L.
Bassett, Lynell V.
Muller, Michael J.
Title Physiological characteristics of dysphagia following thermal burn injury
Journal name Dysphagia   Check publisher's open access policy
ISSN 0179-051X
1432-0460
Publication date 2012
Year available 2011
Sub-type Article (original research)
DOI 10.1007/s00455-011-9376-7
Open Access Status File (Author Post-print)
Volume 27
Issue 3
Start page 370
End page 383
Total pages 14
Place of publication New York, NY, United States
Publisher Springer
Collection year 2012
Language eng
Formatted abstract
The study aim was to document the acute physiological characteristics of swallowing impairment following thermal burn injury. A series of 19 participants admitted to a specialised burn centre with thermal burn injury were identified with suspected aspiration risk by a clinical swallow examination (CSE) conducted by a speech-language pathologist and referred to the study. Once medically stable, each then underwent more detailed assessment using both a CSE and fiberoptic evaluation of swallowing (FEES). FEES confirmed six individuals (32%) had no aspiration risk and were excluded from further analyses. Of the remaining 13, CSE confirmed that two had specific oral-phase deficits due to orofacial scarring and contractures, and all 13 had generalised oromotor weakness. FEES revealed numerous pharyngeal-phase deficits, with the major findings evident in greater than 50% being impaired secretion management, laryngotracheal edema, delayed swallow initiation, impaired sensation, inadequate movement of structures within the hypopharynx and larynx, and diffuse pharyngeal residue. Penetration and/or aspiration occurred in 83% (n = 10/12) of thin fluids trials, with a lack of response to the penetration/aspiration noted in 50% (n = 6/12 penetration aspiration events) of the cases. Most events occurred post swallow. Findings support the fact that individuals with dysphagia post thermal burn present with multiple risk factors for aspiration that appear predominantly related to generalised weakness and inefficiency and further impacted by edema and sensory impairments. Generalised oromotor weakness and orofacial contractures (when present) impact oral-stage swallow function. This study has identified a range of factors that may contribute to both oral- and pharyngeal-stage dysfunction in this clinical population and has highlighted the importance of using a combination of clinical and instrumental assessments to fully understand the influence of burn injury on oral intake and swallowing.
Keyword Deglutition
Deglutition disorders
Fiberoptic endoscopic evaluation of swallowing
Acute dysphagia
Burn injury
Swallowing
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 23 November 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 6 times in Scopus Article | Citations
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Created: Thu, 22 Mar 2012, 11:55:54 EST by Professor Elizabeth Ward on behalf of Speech Pathology and Audiology