Ann Rehabil Med.  2016 Apr;40(2):206-213. 10.5535/arm.2016.40.2.206.

Proposed Use of Thickener According to Fluid Intake on Videofluoroscopic Swallowing Studies: Preliminary Study in Normal Healthy Persons

• Lee KD
• Song SH
• Koo JH
• Park HS
• Kim JS
• Jang KH

• KMID: 2309918
• DOI: http://doi.org/10.5535/arm.2016.40.2.206

Abstract

OBJECTIVE
To examine the characteristics and changes in the pharyngeal phase of swallowing according to fluid viscosity in normal healthy persons, to help determine fluid intake methods in more detail than the use of standardized fluid.
METHODS
This was a prospective observational study involving 10 normal healthy adults. While the participants sequentially took in fluids with 10 different viscosities changes in the pharyngeal phase of the swallowing process were monitored using videofluoroscopic swallowing studies (VFSS). Twenty parameters of the pharyngeal phase, including epiglottis contact, laryngeal elevation, pharyngeal constriction, and upper esophageal sphincter opening, were determined and compared.
RESULTS
No significant viscosity-based changes in epiglottis contact, laryngeal elevation, or upper esophageal sphincter-opening duration of the pharyngeal phase were observed. However, pharyngeal transit time and time from the start of the pharyngeal phase to peak pharyngeal constriction were significantly delayed upon intake of fluid with viscosities of 150.0 centipoise (cP) and 200.0 cP.
CONCLUSION
VFSS analysis of fluid intake may require the use of fluids of various concentrations to determine a suitable viscosity of thickener mixture for each subject.

Keyword

Dysphagia; Viscosity; Thickener

MeSH Terms

Adult
Constriction
Deglutition Disorders
Deglutition*
Epiglottis
Esophageal Sphincter, Upper
Humans
Observational Study
Prospective Studies
Viscosity

Figure

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  Fig. 1 Boundaries of the lateral fluoroscopic view.

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  Fig. 2 The curve of viscosity and BaSO4 dissolved in water (100 mL). The temperature was 21.8℃±2.1℃.

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  Fig. 3 Findings of timing variables according to liquid viscosity in normal subjects. LEC, latency of epiglottis contact; LLE, latency of laryngeal elevation; LPC, latency of pharyngeal constriction; LUEO, latency of upper esophageal sphincter opening; LPLE, latency of peak laryngeal elevation; LPPC, latency of peak pharyngeal constriction; PTT, pharyngeal transit time. a)p<0.05 at 150 cP on LPPC, b)p<0.05 at 200 cP on LPPC, c)p<0.01 at 150 cP on PPT, d)p<0.01 at 200 cP on PPT.

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  Fig. 4 Findings of timing difference variables according to liquid viscosity in normal subjects. LEC, latency of epiglottis contact; LLE, latency of laryngeal elevation; LPC, latency of pharyngeal constriction; LUEO, latency of upper esophageal sphincter opening; LPLE, latency of peak laryngeal elevation; LPPC, latency of peak pharyngeal constriction; PTT, pharyngeal transit time; DLE, duration of laryngeal elevation; DUEO, duration of upper esophageal sphincter opening.

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