Study objectives: The aim of this study was to examine
deglutition in stable patients with COPD and lung hyperinflation.
Design: Twenty consecutive, eligible COPD patients with an
FEV1 ≤ 65% of predicted and a total lung capacity≥
120% of predicted were enrolled prospectively.
Intervention: Patients received a detailed
videofluoroscopic evaluation of oropharyngeal swallowing and were
compared to 20 age-matched and sex-matched historical control
Setting: An outpatient pulmonary
clinic at a Veterans Affairs Medical Center.
and results: The mean total lung capacity, functional residual
capacity, and residual volume for the patients were 128% of predicted,
168% of predicted, and 218% of predicted, respectively. The mean
FEV1 was 39% of predicted. There was no evidence of
tracheal aspiration in either group. The laryngeal position at rest
measured relative to the cervical vertebrae was not different between
groups. The maximal laryngeal elevation during swallowing was
significantly lower in patients with COPD (p < 0.001). Patients with
COPD exhibited more frequent use of spontaneous protective swallowing
maneuvers such as longer duration of airway closure and earlier
laryngeal closure relative to the cricopharyngeal opening than did
control subjects (p < 0.05).
conclude that hyperinflated patients with COPD have an altered
swallowing physiology. We suspect that the protective alterations in
swallowing physiology (swallow maneuvers) may reduce the risk of
aspiration. However, these swallowing maneuvers may not be useful
during an exacerbation and may require further