Objective
To verify the pharyngeal width at rest as a measurement that could be used to assess changes in the degree of dysphagia over time in stroke patients.
Methods
In a cohort of stroke patients, we performed serial measurements of the pharyngeal width at the midpoints of the second (C2) and third (C3) cervical vertebral bodies using lateral neck X-rays while the patients were at rest. The JOSCYL width, a parameter named after the first initial of each developers’ surname and defined as the average value of the upper and lower pharyngeal widths, was used to formulate the JOSCYL scale, which was calculated as the JOSCYL width × 100/neck circumference. All patients also underwent serial videofluoroscopic swallowing studies (VFSSs). The Spearman correlation analysis was used to detect correlations between the serial VFSS results, JOSCYL widths, and JOSCYL scale values.
Results
Over time, we observed significant positive and negative correlations of change in the JOSCYL width and scale with changes in the Penetration-Aspiration Scale and the Dysphagia Outcome and Severity Scale scores, respectively.
Conclusion
The JOSCYL width and JOSCYL scale clearly reflected changes in dysphagia in stroke patients over time. These parameters may provide an easier method for evaluating whether post-stroke dysphagia has been alleviated.

Citations

• Pharyngeal Structure and Dysphagia in Patients with Parkinson’s Disease and Related Disorders
  Eunjee Lee, Gyu Jin Kim, Hyewon Ryu, Kwang-Ik Jung, Woo-Kyoung Yoo, Suk Hoon Ohn
  Dysphagia.2024; 39(3): 468.     CrossRef
• Prediction of Pharyngeal 3D Volume Using 2D Lateral Area Measurements During Swallowing
  Howell Henrian G. Bayona, Yoko Inamoto, Eichii Saitoh, Keiko Aihara, Masanao Kobayashi, Yohei Otaka
  Dysphagia.2024; 39(5): 783.     CrossRef
• The influence of pharyngeal width on post-stroke laryngeal aspiration
  Wonil Kang, Jane Chung, Jeongeun Lee, Kwang-Ik Jung, Woo-Kyoung Yoo, Suk Hoon Ohn
  NeuroRehabilitation.2021; 49(3): 435.     CrossRef

Objective
To develop a new tool for aspiration risk prediction based on pharyngeal width at rest in older adults with symptoms of aspiration.
Methods
Lateral cervical spine roentgenograms were obtained from 33 older adult patients who complained of dysphagia and from 33 healthy, age-matched controls. Pharyngeal width at rest was measured at two points. We named the average of these two pharyngeal widths ‘JOSCYL Width’, calculated ‘JOSCYL Scale’, and compared these parameters between dysphagia and control groups. Correlations of individual JOSCYL Width and JOSCYL Scale, with Penetration Aspiration Scale (PAS) and Dysphagia Outcome and Severity Scale (DOSS) scores were analyzed for the dysphagia group. To determine optimal cutoff points for predicting aspiration, a receiver operating characteristic curve analysis was performed on JOSCYL Width and JOSCYL Scale.
Results
Both JOSCYL Width and JOSCYL Scale of the dysphagia group were larger than those of the control group (p<0.001). The correlation between JOSCYL Width and severity of dysphagia was significant for the dysphagia group (PAS p=0.007; DOSS p=0.012). The correlation between JOSCYL Scale and the severity of dysphagia was also significant for the dysphagia group (PAS p=0.009; DOSS p=0.011). Optimal cutoffs for JOSCYL Width and JOSCYL Scale for predicting aspiration were 20.0 mm and 5.9, respectively.
Conclusion
JOSCYL Width and JOSCYL Scale can be new indicators for predicting aspiration in older adults. They are both precise and easy to use.

Citations

• Pharyngeal Structure and Dysphagia in Patients with Parkinson’s Disease and Related Disorders
  Eunjee Lee, Gyu Jin Kim, Hyewon Ryu, Kwang-Ik Jung, Woo-Kyoung Yoo, Suk Hoon Ohn
  Dysphagia.2024; 39(3): 468.     CrossRef
• Prediction of Pharyngeal 3D Volume Using 2D Lateral Area Measurements During Swallowing
  Howell Henrian G. Bayona, Yoko Inamoto, Eichii Saitoh, Keiko Aihara, Masanao Kobayashi, Yohei Otaka
  Dysphagia.2024; 39(5): 783.     CrossRef
• The influence of pharyngeal width on post-stroke laryngeal aspiration
  Wonil Kang, Jane Chung, Jeongeun Lee, Kwang-Ik Jung, Woo-Kyoung Yoo, Suk Hoon Ohn
  NeuroRehabilitation.2021; 49(3): 435.     CrossRef
• Changes in Pharyngeal Width Over Time as an Indicator of Dysphagia in Stroke Patients
  Seungki Baek, Il Hwan Jung, Ho Young Lee, Jimin Song, Eunsil Cha, Kwang-Ik Jung, Woo-Kyoung Yoo, Suk Hoon Ohn
  Annals of Rehabilitation Medicine.2020; 44(3): 203.     CrossRef

Traumatic brain injury is a main cause of long-term neurological disability, and many patients suffer from cognitive impairment for a lengthy period. Cognitive impairment is a fatal malady to that limits active rehabilitation, and functional recovery in patients with traumatic brain injury. In severe cases, it is impossible to assess cognitive function precisely, and severe cognitive impairment makes it difficult to establish a rehabilitation plan, as well as evaluate the course of rehabilitation. Evaluation of cognitive function is essential for establishing a rehabilitation plan, as well as evaluating the course of rehabilitation. We report a case of the analysis of electroencephalography with global synchronization index and low-resolution brain electromagnetic tomography applied, for evaluation of cognitive function that was difficult with conventional tests, due to severe cognitive impairment in a 77-year-old male patient that experienced traumatic brain injury.

Citations

• Brain health in diverse settings: How age, demographics and cognition shape brain function
  Hernan Hernandez, Sandra Baez, Vicente Medel, Sebastian Moguilner, Jhosmary Cuadros, Hernando Santamaria-Garcia, Enzo Tagliazucchi, Pedro A. Valdes-Sosa, Francisco Lopera, John Fredy OchoaGómez, Alfredis González-Hernández, Jasmin Bonilla-Santos, Rodrigo
  NeuroImage.2024; 295: 120636.     CrossRef
• Criticality and partial synchronization analysis in Wilson-Cowan and Jansen-Rit neural mass models
  Sheida Kazemi, AmirAli Farokhniaee, Yousef Jamali, Gennady S. Cymbalyuk
  PLOS ONE.2024; 19(7): e0292910.     CrossRef
• Structural inequality and temporal brain dynamics across diverse samples
  Sandra Baez, Hernan Hernandez, Sebastian Moguilner, Jhosmary Cuadros, Hernando Santamaria‐Garcia, Vicente Medel, Joaquín Migeot, Josephine Cruzat, Pedro A. Valdes‐Sosa, Francisco Lopera, Alfredis González‐Hernández, Jasmin Bonilla‐Santos, Rodrigo A. Gonza
  Clinical and Translational Medicine.2024;[Epub]     CrossRef