The exams were performed between June 2008 and August 2010, in a major Brazilian university hospital. In this retrospective cohort, we analyzed the medical files and videofluoroscopy exams of 35 patients (study group) diagnosed with neurogenic dysphagia that showed penetration and/or laryngotracheal aspiration and, for this reason, performed the CTM maneuver. 11Ĭonsidering the controversy on its effects and the relevance of this maneuver as one of the first choices for swallowing rehabilitation, 8 12 13 14 we investigated factors that could interfere with the effectiveness of this maneuver in patients with neurogenic dysphagia. In a study involving patients with Parkinson's disease and dementia, CTM was less effective when compared with the intake of thickened liquids. An evidence-based systematic literature review on the impact of dysphagia treatment on populations with neurological disorders found that CTM was effective in 8 to 50% of cases. 3 4 5 6 9 10Īlthough the CTM is widely used to prevent aspiration in patients with dysphagia, some studies question its effectiveness. 2 Such positive effects are however controversial, since some authors have reported no significant modifications in what concerns pharyngeal contraction and even point out some disadvantages concerning the bolus flow from the oral cavity to the pharynx. 1 5 6 7 8 The literature supports that patients who experience delays in the swallowing trigger usually benefit from this maneuver, as it significantly reduces the risk of food aspiration immediately prior to deglutition. 1 2 3 4 5 6 7ĭuring the execution of this maneuver we observe narrowing of the laryngeal portion of the pharynx, which often compensates for delay of glottic closure during swallowing and favors a shift of the tongue base toward the posterior wall of the pharynx. It is the most frequently employed postural maneuver in the treatment of neurogenic oropharyngeal dysphagia caused by encephalic vascular strokes and degenerative diseases. The so-called chin-tuck maneuver (CTM) does not modify the physiology of deglutition however, it does change pharyngeal dimensions as to direct the bolus toward the pharynx and esophagus. Results The results suggest that the effectiveness of chin-tuck maneuver is related to the overall degree of dysphagia: the more severe the dysphagia, the less effective the maneuver.Ĭonclusion Chin-tuck maneuver should benefit dysphagic patients with delay in the swallowing trigger, reduced laryngeal elevation, and difficulties to swallow liquids, but is not the best compensatory strategy for patients with severe dysphagia. Methods In this retrospective cohort, we analyzed the medical files and videofluoroscopy exams of 35 patients (19 male – 54% and 16 female – 46% age range between 20 and 89 years old mean = 69 years). Objective The purpose of this study was to investigate the effectiveness of this maneuver in patients with neurogenic dysphagia and factors that could interfere in it. Introduction The chin-tuck maneuver is the most frequently employed postural maneuver in the treatment of neurogenic oropharyngeal dysphagia caused by encephalic vascular strokes and degenerative diseases.
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