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’s test and Spearman’s
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 ρ = 0.370 for LQ10 and CUP30 (p < 0.001),
ρ = 0.100 for MX and CUP30 (p = 0.312), and ρ =
-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