Pharyngeal width and aspiration after stroke

It is important to assess aspiration in stroke patients. The aim of this study was to develop a new additional tool to predict aspiration based on the pharyngeal width at rest in stroke patients with aspiration symptoms. The pharyngeal width was measured at the middle level of the second and third cervical vertebral bodies using a lateral neck roentgenogram in stroke patients and healthy controls. We named the average of the two pharyngeal widths as the JOSCYL width and calculated the 'JOSCYL width × 100 / neck circumference' as the JOSCYL scale. The correlation between the individual JOSCYL width, JOSCYL scale, and severity of dysphagia was analyzed in the stroke group using Spearman correlation analysis. The optimal cutoff point for predicting aspiration was determined by receiver-operating characteristic curve analysis of the JOSCYL width and JOSCYL scale. The JOSCYL width and JOSCYL scale of the stroke group were larger than those of the control group (P < 0.05). The correlation between the JOSCYL width, JOSCYL scale, and the severity of dysphagia was significant for the whole stroke group and the chronic stroke group (P < 0.05). The optimal cutoffs of the JOSCYL width and JOSCYL scale for predicting aspiration were approximately 18 mm and 50 in the stroke group. The JOSCYL width and JOSCYL scale are new indicators for predicting aspiration in stroke patients and are precise and easy to use. The accuracy of the JOSCYL width and JOSCYL scale for predicting aspiration was shown to be higher in the chronic stroke stage.