MITSUYOSHI YOSHIDA

This study investigated the swallowing dynamics of jelly, thickened liquid, and thin liquid in selected stroke patients who exhibited near-normal swallowing function with screening tests. Videofluoroscopic examination compared the pharyngeal transit time (PTT), pharyngeal delay time (PDT), and laryngeal elevation delay time (LEDT). Of 175 patients (104 men, 71 women; mean age: 68.6 ± 12.0 years) evaluated, 24 (13.7%) experienced aspiration, significantly prolonging LEDT in swallowing thin liquid. PTT did not differ in swallowing jelly, thickened liquid, or thin liquid among the patients who did not aspirate. However, in two-phase analysis of PTT, performed before and after the jelly passed the epiglottis, the former was significantly prolonged, whereas the latter was significantly shortened. PDT was significantly longer with jelly than with thickened and thin liquids. LEDT was significantly longer in swallowing thin liquids. Apparently, the thin liquid reached the pyriform sinus before maximum laryngeal elevation, posing a risk of laryngeal penetration and aspiration during swallowing. A thicker liquid prolonged the time taken to reach the pyriform sinus, reducing aspiration risk. Moreover, oropharyngeal passage of jelly took longer, triggering the swallowing reflex around the vallecula and allowing the jelly to pass through the hypopharynx after laryngeal closure.

ABSTRACT Background There is growing interest in the relationship between oral function and lifestyle‐related diseases. Objectives This study aimed to investigate the associations between the results of oral function tests and those of blood tests for lipid abnormalities, glucose metabolism and kidney function. Methods A total of 118 individuals aged ≥ 50 years (80 men and 38 women) who had undergone health check‐ups at our hospital in 2021 and 2023 were examined. Based on the fasting blood glucose (GLU), HbA1c, high‐density lipoproteins (HDL), low‐density lipoproteins (LDL), urea nitrogen (BUN) and estimated glomerular filtration rate (eGFR) values obtained from the health check‐up results; the subjects were divided into two groups: those with test values outside the reference range in 2021 and/or 2023 and those with test values within the reference range. The results of seven oral function tests were compared between the groups using the Mann–Whitney U test. p < 0.05 was considered significant. Results The group with GLU and HbA1c values outside the reference ranges had significantly lower numbers of remaining teeth (RTN) and oral diadochokinesis (OD) values compared to the group within the reference range. The groups with HDL and LDL values outside the standard ranges had a significantly higher tongue coat index (TCI) and significantly lower OD. Significant differences in TCI and OD/ta/ /ka/ were observed between BUN groups within and outside the reference range. Likewise, significant differences in TCI, RTN and OD/ta/ /ka/ were observed between eGFR groups within and outside the reference range. Conclusions Subjects with blood test values outside the reference range exhibited a decline in oral function, indicating that a decline in oral function might increase the risk of lifestyle‐related diseases and facilitate the progression of frailty.

Abstract Introduction Velopharyngeal insufficiency (VPI) in cleft palate patients often requires surgical intervention. This study evaluates the effectiveness of four‐dimensional computed tomography (4D‐CT) in assessing velopharyngeal function (VPF) pre‐ and postoperatively. Case presentation Four pediatric patients with cleft palate underwent 4D‐CT imaging before and after surgery. Velar length, thickness, elevation angle, and minimum cross‐sectional area were measured during sustained phonation. Conclusion 4D‐CT provided detailed imaging without patient discomfort, allowing both qualitative and quantitative analysis. While surgery improved velopharyngeal motion in most cases, further research is needed to understand the relationship between structural changes and hypernasality outcomes.

OBJECTIVES: Exploring the effects of swallowing function on sleep quality could provide valuable insights into the potential impact of reduced swallowing function on sleep. However, pertinent studies are limited. Therefore, this study aimed to investigate the relationship between dysphagia risk and sleep health in community-dwelling older adults. METHODS: Data for this cross-sectional study were obtained from the Shizuoka and Daiko studies conducted as part of the Japan Multi-Institutional Collaborative Cohort Study. Information on demographics, overall lifestyle, dysphagia risk, as well as sleep quality, duration, satisfaction, and regularity, was obtained using a self-administered questionnaire. Dysphagia risk and sleep quality were assessed using the Dysphagia Risk Assessment Questionnaire for the Community-dwelling Elderly and the Japanese version of the Pittsburgh Sleep Questionnaire Index, respectively. Multivariate logistic regression, adjusted for covariates, was employed to assess the association between dysphagia risk and sleep health. RESULTS: Among the 3058 participants (1633 males, 1425 females) aged ≥60 years, 28.0 % exhibited dysphagia risk, and 19.1 % reported poor sleep quality. Those with dysphagia risk were more likely to experience poor sleep quality than those without dysphagia risk. In male participants, dysphagia was significantly associated with poor sleep quality, unsatisfactory sleep, and sleep irregularity, but was not significantly associated with unsatisfactory or irregular sleep in female participants. The Japanese version of the Pittsburgh Sleep Questionnaire Index components-subjective sleep quality, sleep latency, sleep disturbances, and daytime dysfunction-were associated with dysphagia risk in both sexes. CONCLUSIONS: Dysphagia risk is associated with sleep quality in older individuals in Japan. Thus, preserving swallowing function may contribute to enhancing sleep quality.