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Haruka Tohara

Publications and source records attributed to Haruka Tohara.

4 recordsLinked to original sources

Videofluoroscopic kinesiologic analysis of swallowing: defining a standard plane.

PURPOSE: The Videofluorographic Swallowing Study (VFSS) has become the routine method for assessing swallowing dysfunction and accordingly, much research has been conducted on this procedure. However, due to a lack of standardization of the method of analysis of VFSS, it is often difficult to compare the results of such studies. Therefore, we conducted a comparative study of VFSS's spatial measurement using different standard planes used in the past study and Camper's plane and examined which plane was the most preferable. METHOD: VFSS was performed on 20 healthy young volunteers (26.9 +/- 3 years) and 9 healthy elderly (77.3 +/- 3 years). Each subject swallowed 4ml of thin liquid barium. We measured hyoid displacement and opening of the upper esophageal sphincter (UES) by using four different standard planes. RESULTS: In the young group, the correlation between anterior hyoid displacement and UES opening was significant in all standard planes. In the elderly group, the correlation between anterior hyoid displacement and UES opening was significant only in Camper's plane. Moreover, this plane is hard to be affected by morphological change as ageing. CONCLUSIONS: Camper's plane was found to be as the most preferable plane for analyzing swallowing function.

Adult↗

[The effect of "Oral Wet" for elderly people with xerostomia--the effect of oral rinse containing hialuronan].

Japanese society is aging rapidly, and the number of elderly people is increasing, hence the number of elderly people who have some diseases or disorders is growing. Therefore, Japanese dentists have to cope with various oral symptoms along with aging. Xerostomia is one of the most common symptoms of the elderly, but there is no established treatment. We tried to use an oral rinse "Oral Wet" that contains hialuronan and xylitol for elderly nursing home residents and examined the effect for Xerostomia. The usage of Oral Wet improved hyposalivation and unpleasant oral complaints of the elderly.

Aged↗

Three tests for predicting aspiration without videofluorography.

The videofluorographic swallowing study (VFSS) is the definitive test to identify aspiration and other abnormalities of swallowing. When a VFSS is not feasible, nonvideofluorographic (non-VFG) clinical assessment of swallowing is essential. We studied the accuracy of three non-VFG tests for assessing risk of aspiration: (1) the water swallowing test (3 ml of water are placed under the tongue and the patient is asked to swallow); (2) the food test (4 g of pudding are placed on the dorsum of the tongue and the patient asked to swallow); and (3) the X-ray test (static radiographs of the pharynx are taken before and after swallowing liquid barium). Sixty-three individuals with dysphagia were each evaluated with the three non-VFG tests and a VFSS; 29 patients aspirated on the VFSS. The summed scores of all three non-VFG tests had a sensitivity of 90% for predicting aspiration and specificity of 71% for predicting its absence. The summed scores of the water and food tests (without X-ray) had a sensitivity of 90% and specificity of 56%. These non-VFG tests have limitations but may be useful for assessing patients when VFSS is not feasible. They may also be useful as screening procedures to determine which dysphagia patients need a VFSS.

Adolescent↗

[Dysphagia severity scale].

A simple, broadly applicable, standardized dysphagia severity scale would be useful to standardize dysphagia evaluations, to monitor recovery and efficacy of treatment and to study the consequences of dysphagia. We developed a global Dysphagia Severity Scale (DSS) from videofluorographic swallowing studies which included subjective clinical ratings of functional swallowing. We rated laryngeal penetration/aspiration (P/A) and pharyngeal retention (PR), and then assessed methods for scoring severity of P/A and PR and for combining them in a global scale. Each method was tested by correlation with overall clinical severity ratings. The highest correlations were found by: 1) scoring P/A based on which foods were aspirated (no aspiration or penetration; penetration only; thin liquid aspiration; thick liquid, pudding, or chewed solid food aspiration; 2) scoring PR based on how much food was retained (none; minimal; moderate; severe); and 3) combining P/A and PR by taking the higher of the two scores as the final DSS rating. The final global DSS score and the clinical severity rating correlated well (r = 0.71). This proposed scale shows promise for rating global dysphagia severity.

Adult↗