Dysphagia
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This cross-sectional study investigated the effect of bolus volume on contact pressure within the pharynx and upper esophageal sphincter (UES). Three solid-state manometric pressure sensors were placed transnasally into the pharynx and the proximal esophagus of 40 participants (gender equally represented and between the ages of 20 and 45 years). Participants completed five repetitions each of three swallowing conditions: 5-, 10-, and 20-ml water bolus swallows. ⋯ However, durational measures of UES relaxation pressure were not significantly different between all conditions (p = 0.473). This study demonstrates no significant pressure differences of amplitude and duration between swallowing conditions in the pharynx. At the level of the UES, smaller boluses generated greater negative pressure.
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The 3-ounce water swallow test is frequently used to screen individuals for aspiration risk. Prior research concerning its clinical usefulness, however, is confounded by inadequate statistical power due to small sample sizes and varying methodologies. Importantly, research has been limited to a few select patient populations, thereby limiting the widespread generalizability and applicability of the 3-ounce test. ⋯ In addition, because 71% of participants who failed the 3-ounce water swallow test were deemed safe for an oral diet, nonsuccess on the 3-ounce water swallow test is not indicative of swallowing failure. The clinical utility of the 3-ounce water swallow test has been extended to include a wide range of medical and surgical diagnostic categories. Importantly, for the first time it has been shown that if the 3-ounce water swallow test is passed, diet recommendations can be made without further objective dysphagia testing.