Relationship between the Incidence of Vocal Cord Palsy and Aspiration Risk in Acute Ischemic Stroke Patients.

, Lee, Keong Woo; , Kim, Sang Beom; , Lee, Jong Hwa; , Kim, Young Dong; , Han, Dong Wook; , Kim, Tae Hyoung; , An, Joong Ki

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2010;34(1):15-19.

Lee, Keong Woo , Kim, Sang Beom , Lee, Jong Hwa , Kim, Young Dong , Han, Dong Wook , Kim, Tae Hyoung , An, Joong Ki

¹Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Korea. expansion21@hanmail.net
²Department of Otorhinolaryngology, Dong-A University College of Medicine, Korea.

급성 뇌경색 환자에서 성대 마비의 빈도와 흡인 위험성과의 상관관계

이경우, 김상범, 이종화, 김영동, 한동욱, 김태형, 안중기¹

동아대학교 의과대학 재활의학교실, ¹이비인후과학교실

Abstract

Objective
To investigate the incidence of vocal cord palsy (VCP) in acute ischemic stroke patients and its influence on aspiration risk.
Method
Fifty patients with first-ever acute stroke were enrolled. The mean age was 68.3 years and there were 21 men and 29 women. Based on clinical and neuroimaging findings, their stroke subtype was categorized into cortical/ subcortical (Group A), lateral medulla (Group B) and other brainstem (Group C). We examined them by using flexible fiberoptic rhinolaryngoscope and videofluroscopic swallowing study (VFSS) within 2 weeks after stroke onset. The Penetration - Aspiration Scale (PAS) was used to score each VFSS.
Results
Among the 50 patients, VCP was found in 15 (30%): 15.8% of group A, 100% of group B and 40% of group C. VCP was contralateral to the brain lesion in group A and ipsilateral in 85.7% of group B. Aspiration risk was found in 38% of the all patients and 53% of VCP had aspiration risk. No differences in the incidence of aspiration risk were noted according to VCP (՗²=2.138, p=0.144).
Conclusion
There was no relationship between VCP and aspiration risk in acute ischemic stroke patients. Although VCP is a known risk factor for aspiration, other factors are important in determining an effective swallowing. (J Korean Acad Rehab Med 2010; 34: 15-19)

Key Words: Vocal cord palsy, Dysphagia, Videofluoroscopic swallowing study