The influence of pharyngeal width on post-stroke laryngeal aspiration.

BACKGROUND Laryngeal penetration, which is a less serious form of aspiration, should be considered in patients with stroke to ensure early detection of risk of laryngeal aspiration and prevention of pneumonia. OBJECTIVE As a follow-up to a previous study that demonstrated the association of pharyngeal width to laryngeal aspiration, the present study sought to determine whether the pharyngeal width was related to not only laryngeal aspiration but also laryngeal penetration in patients with deglutition disorder following stroke. METHODS The pharyngeal width on the roentgenogram was measured and compared based on the severity of aspiration. Moreover, the optimal cut-off points were determined for predicting the penetration and aspiration so that the difference between the penetration and the aspiration could be elucidated. RESULTS The pharyngeal width of the patients was wider than the controls. The increase of the pharyngeal width by aspiration severity was more evident in the patients with chronic and right cerebral stroke. The optimal cut-off point of the pharyngeal width was approximately 1 mm lesser for the prediction of penetration than for aspiration. CONCLUSIONS The pharyngeal width could be an ancillary method for detecting penetration and aspiration in stroke patients.