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Biomedical subjects

W G Selley

Publications and source records attributed to W G Selley.

15 recordsLinked to original sources
PubMed1992

Dysphagia in cerebral palsy: a comparative study of the Exeter Dysphagia Assessment Technique and a multidisciplinary assessment.

Eighteen children with cerebral palsy in a special school, most of whom had feeding difficulties, were studied to compare the diagnostic value of the Exeter Dysphagia Assessment Technique (EDAT) with an exhaustive clinical assessment undertaken by a multidisciplinary team experienced in the diagnosis and treatment of dysphagia of neurological origin. Four feeding skills were assessed by each method independently, viz. anticipation, intraoral sensory perception, oral-motor efficiency, and pharyngeal triggering. Comparison of the two sets of results showed agreement in at least 78% of the assessed skills. The possible reasons for the few discrepancies are discussed. The noninvasive EDAT equipment was easy to use with the children, who had a range of type and severity of cerebral palsy. The test was undertaken in their familiar surroundings and took 15 to 20 min per child. Interpretation of the results showed that EDAT provided a rapid, reliable diagnostic aid which assisted in the assessment of the degree of feeding impairment within each of the four feeding skills tested.

Adolescent↗
PubMed1990

The Exeter Dysphagia Assessment Technique.

The Exeter Dysphagia Assessment Technique (EDAT) uses noninvasive equipment to record, simultaneously, "feeding respiratory patterns," the time drink entered the mouth, and associated swallow sounds during feeding. The easily portable equipment enabled patients' swallowing ability to be tested, at the bedside if necessary, using a small amount of fruit-flavored drink. The results appear in chart form. EDAT findings from groups of normal subjects aged 2-90 years were compared with those from patients with dysphagia of neurologic origin and normal subjects under experimental feeding conditions. The results revealed maturation of the feeding respiratory pattern in the teenage years and remarkable consistency thereafter. Differences in the recordings between the normal and abnormal subjects were sufficiently marked to allow the findings to be used in the diagnosis of other patients with dysphagia of doubtful neurologic cause. Interpretation of the charts and recorded timings of the oral and pharyngeal stages of swallowing permitted a more accurate identification of sensory nerve, motor nerve, and functional involvement causing dysphagia of neurologic origin and may be used as a guide to the origin of the sensory deficit.

Adolescent↗
PubMed1990

Coordination of sucking, swallowing and breathing in the newborn: its relationship to infant feeding and normal development.

Non-invasive, sensitive equipment was designed to record nasal air flow, the timing and volume of milk flow, intraoral pressure and swallowing in normal full-term newborn babies artificially fed under strictly controlled conditions. Synchronous recordings of these events are presented in chart form. Interpretation of the charts, with the aid of applied anatomy, suggests an hypothesis of the probable sequence of events during an ideal feeding cycle under the test conditions. This emphasises the importance of complete coordination between breathing, sucking and swallowing. The feeding respiratory pattern and its relationship to the other events was different from the non-nutritive respiratory pattern. The complexity of the coordinated patterns, the small bolus size which influenced the respiratory pattern, together with the coordination of all these events when milk was present in the mouth, emphasise the importance of the sensory mechanisms. The discussion considers (1) the relationship between these results, those reported by other workers under other feeding conditions and the author's (WGS) clinical experience, (2) factors which appear to be essential to permit conventional bottle feeding and (3) the importance of the coordination between the muscles of articulation, by which babies obtain their nourishment in relation to normal development and maturation.

Child Development↗
PubMed1989

Respiratory patterns associated with swallowing: Part 1. The normal adult pattern and changes with age.

Simple, non-invasive equipment was designed to record respiratory patterns associated with swallowing food or drink in young and elderly healthy adults, to compare with neurologically impaired patients who complained of dysphagia. The timing of the entry of the test drink from a spoon into the mouth, the swallow event and respiration were recorded electronically and were presented in chart form. The equipment proved to be easy to use and the results were consistent. All 33 subjects showed a well-defined respiratory pattern, with individual minor variations, but different from the pattern of their resting respiration. The direction of respiration during spoon contact was consistent for each individual and the pharyngeal stage of swallowing was almost always followed by a large expiration. Thus the resting respiration is not simply arrested during swallowing, but is substituted by a different, well-controlled pattern.

Adult↗
PubMed1989

Respiratory patterns associated with swallowing: Part 2. Neurologically impaired dysphagic patients.

The co-ordination of respiration and swallowing was recorded electronically in three groups of patients who complained of dysphagia following a stroke, or associated with multiple sclerosis or motor neurone disease. The test used was simple and the equipment easily taken to the patient, in bed if necessary. All the patients showed differences from normal subjects and there were differences between each of the neurologically impaired groups. The technique appears to allow an assessment of the state of oropharyngeal motor and sensory functions separately during swallowing.

Adolescent↗
PubMed1987

The effect of tongue position on division of airflow in the presence of velopharyngeal defects.

Results of studies of nasal to oral airflow ratios are reported using simple and accurate anatomical models to record the effect of differing positions of lips, tongue and soft palate, with particular reference to the effect of the position of the dorsum of the tongue and various sizes of velopharyngeal defect. The resistances to airflow produced by the labial, palatolingual, velopharyngeal and naral valves were found to be interdependent. Variations in tongue position alone could allow the same nasal airflow during a more than three-fold variation in the size of velopharyngeal defects. The degree of nasal escape of air which is responsible for the typical "cleft palate" type of speech cannot be assessed by observation of the size of the velopharyngeal defect alone.

Cleft Palate↗
PubMed1986

A new way to treat sucking and swallowing difficulties in babies.

Experience from the use of feeding plates for babies with cleft palate and from the treatment of dysphagia in patients recovering from stroke led to the design of a simple intraoral appliance. This device has been used successfully in treating twelve babies with feeding difficulties caused by incoordination, when other methods had failed.

Deglutition Disorders↗
PubMed1985

Swallowing difficulties in stroke patients: a new treatment.

Difficulty with swallowing is one of the most distressing symptoms experienced by patients who have suffered strokes and one which previously has been particularly difficult to help. An intra-oral appliance which stimulates the involuntary swallowing mechanism has been tested with 170 consecutive stroke patients with dysphagia and drooling, and the results show substantial improvement. The appliance is relatively cheap to construct and fit, requiring little professional time. It is worn during the whole day, helping to rehabilitate the swallowing mechanism with saliva as well as with food and drink. The treatment is appropriate for patients in hospital or at home and avoids the use of medication.

Adult↗