Self-reported Dysphagia and Pharyngeal Volume Following Whiplash Injury

D. Stone*, E. C. Ward, H. Bogaardt, R. Heard, B. Martin-Harris, A. C. Smith, J. M. Elliott

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Difficulty swallowing has been reported following whiplash injury; however, the reasons remain poorly understood. A possible factor may be the observed changes in pharyngeal volume. The current exploratory study was designed to examine the prevalence of self-reported dysphagia after whiplash and the relationship with recovery status and change in pharyngeal volume. Data were available from a longitudinal study of adults with whiplash. Data included magnetic resonance imaging (MRI) of the cervical spine, the Dysphagia Handicap Index (DHI), and Neck Disability Index (NDI) collected over four timepoints (< 1 week, 2 weeks, 3 months, and 12 months post-injury). Initial cross-sectional analysis examined 60 patients with DHI data from at least one timepoint. A second, longitudinal analysis was conducted on 31 participants with MRI, NDI, and DHI data at both early (< 1–2 weeks) and late (3–12 months) timepoints. The pharynx was contoured on axial T2-weighted MRI slices using OsiriX image processing software and pharyngeal volume (mm3) was quantified. In the 60-patient cohort, prevalence of self-reported dysphagia (DHI ≥ 3) was observed in 50% of participants at least once in 12 months (M = 4.9, SD 8.16, range 0–40). In the longitudinal cohort (n = 31), mean total DHI significantly (p = 0.006) increased between early and late stages. There was no relationship (p = 1.0) between dysphagia and recovery status, per the NDI% score. Pharyngeal volume remained stable and there was no relationship between dysphagia and pharyngeal volume change (p = 1.0). This exploratory study supports the need for further work to understand the nature of dysphagia, extent of functional compromise, and the underlying pathophysiology post-whiplash.

Original languageEnglish (US)
Pages (from-to)1019-1030
Number of pages12
JournalDysphagia
Volume36
Issue number6
DOIs
StatePublished - Dec 2021

Keywords

  • Deglutition
  • Deglutition disorders
  • Dysphagia
  • Pharyngeal volume
  • Swallowing
  • Whiplash
  • Whiplash-associated disorders

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

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