Incidence, Risk Factors and Recovery of Laryngeal Penetration-Aspiration after Traumatic Cervical Spinal Cord Injury

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Arvo building, auditorium F115, address: Arvo Ylpön katu 34

Tiina Ihalainen

Doctoral defence of M.A. Tiina Ihalainen

Incidence, Risk Factors and Recovery of Laryngeal Penetration-Aspiration after Traumatic Cervical Spinal Cord Injury

The field of science of the dissertation is Logopedics.

The opponent is Professor Emeritus Matti Lehtihalmes (University of Oulu). Professor Anna-Maija Korpijaakko-Huuhka acts as the custos.

The language of the dissertation defence is Finnish.

Assessment of swallowing function is an essential part of the acute care of the traumatic cervical spinal cord injury

In her doctoral dissertation, Tiina Ihalainen, M.A., examined the incidence, risk factors and recovery of swallowing difficulties in adult patients with a cervical spinal cord injury resulting from an accident. Ihalainen´s study sample consisted of 46 patients with acute traumatic cervical spinal cord injury admitted to Tampere University Hospital.

Traumatic cervical spinal cord injury is a life-changing incident, as it results in tetraplegia that is a partial or complete loss of motor and sensory function in the arms, trunk, pelvic organs, and legs. Furthermore, damage to the spinal cord causes changes in autonomic nervous system such as cardiovascular and respiratory system, urinary bladder, bowel, and sexual organs. Thus, the injury may have devastating consequences for the physical, economical, and psychosocial well-being of patients and their loved ones. In Finland, about 500 new spinal cord injuries are reported annually, and 40% of these are caused by an accident. Nearly two-thirds of these injuries result in tetraplegia.

Based on Ihalainen’s thesis, about half of the patients (48%) had swallowing difficulties that led to penetration-aspiration. Aspiration means that the swallowed material enters into the airways. Whereas in penetration the material enters the laryngeal vestibule but remains above the vocal cords. The rather high incidence rate of penetration-aspiration indicates that a routine evaluation of swallowing is highly recommendable before initiating oral feeding. Aspiration is considered to be a risk factor for pneumonia. Thus, early identification of the patients with an increased risk for aspiration, is critical to ensure safe nutrition and optimal pulmonary function.

However, the current study suggests that the propensity for penetration-aspiration is a transient phenomenon among patients with traumatic cervical spinal cord injury. The majority of these patients (88%) achieve a total oral intake without restrictions within the first few months after injury.

Tiina Ihalainen has completed her master’s degree in logopedics in 2008 at the University of Oulu (Oulu, Finland). Currently, she works as a speech therapist in a neurological rehabilitation ward at the Tampere University Hospital (Tampere, Finland). In Finland, the acute care, subacute rehabilitation, and lifelong follow-up care of patients with traumatic spinal cord injuries are centralized to three university hospitals, which are situated in Helsinki, Oulu, and Tampere.


The dissertation is published in the publication series of Acta Universitatis Tamperensis; 2436, Tampere University Press, Tampere 2018. The dissertation is also published in the e-series Acta Electronica Universitatis Tamperensis; 1949, Tampere University Press 2018.

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