Original Article

The risk of laryngeal penetration or aspiration among discrete, sequential, and chew-swallowing

Mao Ogawa, MD, Hitoshi Kagaya, MD, DMSc, Megumi Ozeki, MD, DMSc, Kaori Kikumura, MD, Seiko Shibata, MD, DMSc, Eiichi Saitoh, MD, DMSc
Jpn J Compr Rehabil Sci 10: 77-81, 2019

Objective: To compare three different types of swallowing-discrete swallowing, sequential swallowing, and chew-swallowing-in terms of the risk of laryngeal penetration and aspiration.
Methods: Between January 2011 and May 2016, 136 patients underwent videofluoroscopic examination of swallowing without the use of compensation techniques while they swallowed 10 mL of liquid (discrete swallowing: LQ10), 30 g of liquid from a cup (sequential swallowing: CUP30), and a mixture of 5 mL of liquid and 4 g of corned beef (chewswallowing: MX) in the sitting position. We assessed the presence or absence of laryngeal penetration and aspiration during swallowing the three types of boluses. The degree of difficulty and Penetration- Aspiration Scale (P-A Scale) for each bolus were investigated using McNemarfs test and Spearmanfs rank correlation coefficient, respectively.
Results: Laryngeal penetration was observed in 73 patients for LQ10, 62 for MX, and 97 for CUP30, indicating that there were significantly more patients for CUP30 than LQ10 (p < 0.001) and MX (p < 0.001). Aspiration was observed in 8 patients for LQ10, 14 for MX, and 20 for CUP30. There were significantly more cases of aspiration for CUP30 than LQ10 (p = 0.009). The correlation coefficients for the P-A Scale for each bolus were ƒÏ = 0.370 for LQ10 and CUP30 (p < 0.001), ƒÏ = 0.100 for MX and CUP30 (p = 0.312), and ƒÏ = -0.202 for MX and LQ10 (p = 0.055).
Conclusions: The frequency of laryngeal penetration was highest for CUP30, followed by that for LQ10 and MX; the frequency of aspiration was highest for CUP30, followed by that for MX and LQ10. There was no statistically significant correlation for P-A Scale between MX and LQ10 nor MX and CUP30.

Key words: discrete swallowing, sequential swallowing, chew-swallowing, laryngeal penetration, aspiration

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