Muscle Tension Dysphagia: An Expanded Investigation of Clinical Presentations and Swallowing Kinematics.

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Bibliographic Details
Title:	Muscle Tension Dysphagia: An Expanded Investigation of Clinical Presentations and Swallowing Kinematics.
Authors:	Buckley, Daniel P.^1,2,3 buckleyd@bu.edu, Borders, James C.⁴, Pisegna, Jessica M.^1,2,3
Source:	American Journal of Speech-Language Pathology. Jul2024, Vol. 33 Issue 4, p1802-1810. 9p.
Subject Terms:	Retrospective studies, Quality of life, *Inter-observer reliability, Reference values, Laryngeal muscles, Kinematics, Questionnaires, Research evaluation, Descriptive statistics, Muscle tone, Laryngoscopy, Medical records, Acquisition of data, Hyoid bone, Intraclass correlation, Deglutition, Health outcome assessment, Confidence intervals, Data analysis software, Deglutition disorders, Symptoms
Abstract:	Purpose: This study retrospectively examined patient-reported symptoms, quality of life, and swallowing kinematics in individuals with presumed muscle tension dysphagia (MTDg). Method: Twenty-six individuals met the inclusion criteria. Data were gathered from patient-reported outcome measures (PROs), symptomology, clinician reports of palpation, and hyolaryngeal and hyoid movements measured on a 20-ml thin liquid bolus during videofluoroscopic swallowing studies. Results: All PROs were outside of typical limits, except for the Voice Handicap Index-10. Mean hyoid excursion was 1.52 cm (SD = 0.46, range: 0.76-2.43), and hyolaryngeal excursion was 0.77 cm (SD = 0.44, range: -0.42-1.68). A minority of participants (4%-19%) demonstrated atypical hyoid and/or hyolaryngeal excursion compared to the available normative reference value sets. Conclusions: Individuals demonstrated abnormalities in the clinical evaluation of the areas of palpation and reported perilaryngeal discomfort and symptoms of laryngeal hyperresponsiveness, with a negative impact on their quality of life across various PROs. Atypical hyoid and/or hyolaryngeal excursion during swallowing was rare when compared to available normative reference values. The clinical evaluation of MTDg may be enhanced by including components related to muscle tension and laryngeal hyperresponsiveness in order to differentiate MTDg from idiopathic functional dysphagia and lead the patient to the otolaryngology/speech-language pathology clinic for intervention and management. [ABSTRACT FROM AUTHOR]
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Database:	Education Research Complete

Description
Abstract:	Purpose: This study retrospectively examined patient-reported symptoms, quality of life, and swallowing kinematics in individuals with presumed muscle tension dysphagia (MTDg). Method: Twenty-six individuals met the inclusion criteria. Data were gathered from patient-reported outcome measures (PROs), symptomology, clinician reports of palpation, and hyolaryngeal and hyoid movements measured on a 20-ml thin liquid bolus during videofluoroscopic swallowing studies. Results: All PROs were outside of typical limits, except for the Voice Handicap Index-10. Mean hyoid excursion was 1.52 cm (SD = 0.46, range: 0.76-2.43), and hyolaryngeal excursion was 0.77 cm (SD = 0.44, range: -0.42-1.68). A minority of participants (4%-19%) demonstrated atypical hyoid and/or hyolaryngeal excursion compared to the available normative reference value sets. Conclusions: Individuals demonstrated abnormalities in the clinical evaluation of the areas of palpation and reported perilaryngeal discomfort and symptoms of laryngeal hyperresponsiveness, with a negative impact on their quality of life across various PROs. Atypical hyoid and/or hyolaryngeal excursion during swallowing was rare when compared to available normative reference values. The clinical evaluation of MTDg may be enhanced by including components related to muscle tension and laryngeal hyperresponsiveness in order to differentiate MTDg from idiopathic functional dysphagia and lead the patient to the otolaryngology/speech-language pathology clinic for intervention and management. [ABSTRACT FROM AUTHOR]
ISSN:	10580360
DOI:	10.1044/2024_AJSLP-23-00415