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Rehabilitacion 2002;36:388-92 - DOI: 10.1016/S0048-7120(02)73311-2
Alteraciones de la deglución en el paciente afecto de traumatismo craneoencefálico
Swallowing disorders in the cranioencephalic traumatism affected patient
I. Villarreal Salcedo, H. Bascuñana Ambrós**,, , E. García García***
* Departamento de RHB. Hospital Universitario Miguel Servet. Zaragoza.
** Servicio de RHB. MATT. Tarragona y GECIP-u-TCE. Barcelona.
* Departamento de Rehabilitación. Unidad de Foniatría y Logopedia. Hospital Universitario Miguel Servet, Zaragoza.
Resumen

El traumatismo craneoencefálico (TCE) es una causa de disfagia neurológica todavía no bien estudiada. Su incidencia oscila entre un 25–71% de los TCE ingresados en rehabilitación y tiene un pronóstico favorable si se evalúa y trata de forma adecuada. Los factores de riesgo asociados a la disfagia en el TCE son: valores de la Escala del Coma de Glasgow inferiores a seis al ingreso; niveles I-II en la Escala Cognitiva de Rancho los Amigos; duración del coma; presencia de intubación orotraqueal durante un período superior a dos semanas y traqueostomía. Los trastornos deglutorios más frecuentes son de alteración de la movilidad o coordinación de la lengua y retraso o ausencia del reflejo deglutorio faríngeo. Otras alteraciones no deglutorias que también interfieren con la alimentación oral en el TCE son los trastornos de conducta, las habilidades cognitivas y la anosognosia. La valoración y tratamiento de la disfagia en el TCE no difiere de otras discapacidades neurológicas.

Summary

Cranioencephalic traumatism (CET) is a cause of neurological dysphagia that has still not been well studied. Its incidence ranges from 25%-71% of the CETs admitted to rehabilitation and it has a favorable prognosis if it is assessed and treated adequately. Risk factors associated to dysphagia in the CET are: values of the Glasgow Coma Scale lower than 6 on admission; levels I-II on the Rancho los Amigos Cognitive Scale; duration of coma, presence or orotracheal intubation for a period over two weeks and tracheostomy. The most frequent swallowing disorders are alteration of tongue mobility or coordination and delay or absence of pharyngeal swallow reflex. Other non-swallowing disorders that also interfere with oral feeding in CET are behavior disorders, cognitive abilities and anosognosia. Assessment and treatment of dysphagia in CET do not differ from other neurological incapacities.

Palabras clave
Traumatismo craneoencefálico, Disfagia, Riesgo, Valoración, Tratamiento
Key words
Cranioencephalic traumatism, Dysphagia, Risk, Assessment, Treatment
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Bibliografía
1.
C.J. Winstein
Neurogenic dysphagia: frecuency, progression, and outcome in adults following head injury
Phys Ther, 63 (1983), pp. 1992-1996
2.
H. Bascuñana
Disfagia neurológica. Generalidades. Características en el accidente vascular cerebral, en el traumatismo craneoencefálico y en la parálisis cerebral infantil
Rehabilitación (Madr), 32 (1998), pp. 331-336
3.
M.J. Schurr,K.A. Ebner,A.L. Maser,K.B. Sperling,R.B. Helgerson,B. Harr
Formal swallowing evaluation and therapy after traumatic brain injury improves dysphagia outcomes
J Trauma, 46 (1999), pp. 817-821
4.
L.H. Field,C.J. Weiss
Dysphagia with head injury
Brain Inj, 3 (1989), pp. 19-26
5.
L.E. Mackay,A.S. Morgan,B.A. Bernstein
Swallowing disorders in severe brain injury: risk factors affecting return to oral intake
Arch Phys Med Rehabil, 80 (1999), pp. 365-371
6.
L.R. Cherney,S. Halper
Swallowing problemas in adults with traumatic brain injury. J Head Trauma Rehabil
Semin Neurol, 16 (1996), pp. 349-353
7.
J.A. Logemann
Evaluation of swallowing Disorders
Evaluation and treatment of swallowing disorders, 2.ª ed,
8.
C.L. Lazarus,J.A. Logemann
Swallowing disorders in closed head trauma patients
Arch Phys Med Rehabil, 68 (1987), pp. 79-87
9.
H. Bascuñana
Diagnóstico de la disfagia neurológica
Rehabilitación (Madr), 32 (1998), pp. 324-330
10.
J. Pepe,A.S. Morgan,L.E. Mackay
The metabolic response to acute traumatic brain injury and associated complications
Maximizing brain injury recovery: integrating critical care and early rehabilitation, pp. 396-443
11.
S.R. Petersen,M. Jeevanandam,T. Harrington
Is the metabolic response to injury different with o without severe head injury?: significance of plasma glutamine levels
J Trauma, 34 (1993), pp. 653-661
12.
B. Young,L. Ott,B. Yingling,C. McClain
Nutrition and brain injury
J Neurotrauma, 9 (1992), pp. 375-385
13.
D.C. Tepid,J.B. Palmer,Linden
Management of dysphagia in a patient with closed head injury: a case report
Dysphagia, 1 (1987), pp. 221-226
14.
M. Ylvisaker,J.A. Logemann
Therapy for feeding and swallowing following head injury
Management of head injuried patients,
15.
L.R. Cherney,A.S. Halper
Recovery of oral nutrition after head injury in adults
J Head Trauma Rehabil, 4 (1989), pp. 42-50
16.
N. Aguilar,M. Olson,D. Shedd
Rehabilitation of deglutition problems in patients with head and neck cancer
American Journal of Surgery, 138 (1979), pp. 501-507
17.
K.M. Nathadwarawala,A. McGroary,C.M. Wiles
Swallowing in neurological outpatients: use of a timed test
Dysphagia, 9 (1994), pp. 120-129
18.
L. Martens,T. Cameron,M. Simonsen
Effects of a multidisciplinary management program on neurologically impaired patients with dysphagia
Dysphagia, 5 (1990), pp. 147-151
19.
J.A. Logemann,P. Kahrilas,M.K. Kobara,N. Vakil
The benefit of head rotation on pharyngoesophageal dysphagia
Arch Phys Med Rehabil, 70 (1989), pp. 767-771
20.
A. Rasley,J.A. Logemann,P.J. Kahrilas,A.W. Rademaker,B.R. Pauloski,W.J. Dodds
Prevention of barium aspiration during videofluoroscopic swallowing studies: value of change in posture
Am J Roentgenol, 160 (1993), pp. 1005-1009
21.
W. Drake,S. O’Donoghue,C. Bartram,J. Lindsay,R. Greenwood
Eating in side-lying facilitates rehabilitation in neurogenic dysphagia
Brain Injury, 11 (1997), pp. 137-142
22.
M.V. Welch,J.A. Logemann,A.W. Rademaker,P.J. Kahrilas
Changes in pharyngeal dimensions effected by chin tuck
Arch Phys Med Rehabil, 74 (1993), pp. 178-181
23.
J.A. Logemann
Management of the patient with oropharyngeal swallowing disorders
Evaluation and treatment of swallowing disorders 2ª ed, pp. 191-250
24.
G. Lazzara,C. Lazarus,J.A. Logemann
Impact of thermal stimulation on the triggering of the swallowing reflex
Dysphagia, 1 (1986), pp. 73-77
25.
J.A. Logemann
Manual for the videofluoroscopic study of swallowing (2ª ed), PRO-ED, (1993)
26.
B.J.W. Martin,J.A. Logemann,R. Shaker,W.J. Doods
Normal laryngeal valving patterns during three breath-hold maneuvers: a pilot investigation
Dysphagia, 8 (1993), pp. 11-20
27.
M. Fujiu,J.A. Logemann
Effect of a tongue holding maneuver on posterior pharyngeal wall movement during deglutition
Am J Speech Lang Pathol, 5 (1996), pp. 23-30
28.
P.J. Kahrilas,J.A. Logemann,G.A. Ergun,F. Facchini
Volitional augmentation of upper esophageal sphincter opening during swallowing
Am J Physiol, 260 (1991), pp. 450-456
29.
V.V. Raut,G.J. McKee,B.T. Johnston
Effect of bolus conssitency on swallwing: does altering consistency help?
Eur Arch Otorhinolaryngol, 258 (2001), pp. 49-53
Correspondencia: Servicio de RHB. Clínica MATT C/ Pin i Soler, 12 43002 Tarragona
Copyright © 2002. Sociedad Española de Rehabilitación y Medicina Física (SERMEF) y Elsevier España, S.L.