Investigation of compensatory postures with videofluoromanometry in dysphagia patients

AIM： To investigate the effectiveness of head compensatory postures to ensure safe oropharyngeal transit. METHODS： A total of 321 dysphagia patients were enrolled and assessed with videofluoromanometry （VFM）. The dysphagia patients were classified as follows： safe transit; penetration without aspiration; aspiration before, during or after swallowing; multiple aspirations and no transit. The patients with aspiration or no transit were tested with VFM to determine whether compensatory postures could correct their swallowing disorder. RESULTS： VFM revealed penetration without aspiration in 71 patients （22.1%）; aspiration before swallowing in 17 patients （5.3%）; aspiration during swallowing in 32 patients （10%）; aspiration after swallowing in 21 patients （6.5%）; multiple aspirations in six patients （1.9%）; no transit in five patients （1.6%）; and safe transit in 169 patients （52.6%）. Compensatory postures guaranteed a safe transit in 66/75 （88%） patients with aspiration or no transit. A chin-down posture achieved a safe swallow in 42/75 （56%） patients, a head-turned posture in 19/75 （25.3%） and a hyperextended head posture in 5/75 （6.7%）. The compensatory postures were not effective in 9/75 （12%） cases. CONCLUSION： VFM allows the speech-language therapist to choose the most effective compensatory posture without a trial-and-error process and check the effectiveness of the posture.