Swallowing in Obese Individuals before and after Bariatric Surgery
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Swallowing in Obese Individuals before and after Bariatric Surgery Luana Casari Parreira 1 & Wilson Salgado-Junior 2 & Roberto Oliveira Dantas 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate the oral and pharyngeal phases of swallowing in obese patients before and after bariatric surgery. Material and Method Swallowing was evaluated by videofluoroscopy before and after 80 to 123 days from bariatric surgery in 19 individuals with obesity (15 women), aged 25–60 years. The body mass index (BMI) before surgery was from 40.1 to 57.0 kg/ m2. The surgical treatment was performed with laparoscopic Roux-en-Y gastric by-pass (RYGB). After surgery, the BMI ranged from 31.7 to 48.4 kg/m2. The control group had 19 healthy volunteers (15 women), aged 22–56 years and BMI from 19.4 to 29.7 kg/m2. Swallowing was evaluated with swallows of 5 mL of liquid and paste boluses in triplicate, and a solid bolus in duplicate. Results With swallowing of liquid bolus, individuals with obesity had, before and after surgery, an increased frequency of premature posterior spillage. Before the surgery, the obese subjects had longer pharyngeal clearance of liquid compared with the control group and with individuals after the surgery. After the surgery, obese individuals had longer duration of the hyoid movement with liquid and paste boluses, compared with before surgery. Also, there was a reduction of the interval between the bolus entering the phaynx and the onset of upward hyoid excursion. Conclusion Non-operated obese patients had a longer pharyngeal clearance for liquid bolus compared with healthy controls. After bariatric surgery, there was an increase in hyoid movement duration. Keywords Swallowing . Deglutition . Obesity . Obesity surgery . Dysphagia . Deglutition disorder
Introduction Individuals with grade III obesity have a narrower oropharyngeal airway due to enlargement of surrounding soft tissues, which can cause obstruction of the airway [1] and impaired bolus transit.The fat deposited on the lateral pharyngeal wall * Roberto Oliveira Dantas [email protected] Luana Casari Parreira [email protected] Wilson Salgado-Junior [email protected] 1
Department of Ophtalmology, Otorynolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
2
Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
3
Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, SP 14049-900, Brazil
and posterior tongue appears to play an important role for the narrowing of the upper airway and in the development of obstructive sleep apnea [2]. Furthermore, excessive central fat deposition may decrease lung volumes and longitudinal tension of the pharyngeal airway wall [2]. The precise coordination of breathing and swallowing is essential for airway protection and bolus flow through the pharyn
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