Correlation Between Pharyngeal Residue and Aspiration In Fiberoptic Endoscopic Evaluation of Swallowing – An Observational Study

Publication date: Available online 27 June 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Yael Shapira-Galitz, Hagit Shoffel-Havakuk, Doron Halperin, MHA Yonatan Lahav
ObjectivesTo examine the correlation between pharyngeal residue severity and clearance to penetration-aspiration on FEES.DesignRetrospective cohort.SettingKaplan Medical Center dysphagia clinic.Participants110 patients visiting a dysphagia clinic between 2014-2016 undergoing FEES.InterventionsFEES were scored for penetration-aspiration with the penetration-aspiration scale (PAS), for residue severity using the Yale Pharyngeal Residue Severity Rating Scale, YPR-SRS. The numbers of swallows required to clear the pharynx were recorded. The first and the worst bolus challenge for each consistency (liquid, purée and solid) were analyzed.Main Outcome MeasuresYPR-SRS and number of clearing swallows were correlated with the PAS of the same bolus challenge.ResultsThe study population's mean age was 67±13.4 years; 54% were males (n=58). A significant correlation was found between the YPR-SRS and the PAS for all consistencies tested, in each anatomical site (vallecula or pyriform sinus) and for both the first and worst bolus challenge (p<0.001 for all). The correlation of residue with aspiration was stronger when vallecula and pyriform sinuses scores were summated (Pearson's correlation coefficient=0.573/0.631/0.446 for liquid/purée/solid for worst bolus challenge). Incorporating the number of clearing swallows to the YPR-SRS strengthened the correlation with PAS.ConclusionsResidue severity and clearance correlate with penetration/aspiration on FEES. The YPR-SRS can be applied to standardize description of residue in FEES and to aid in dysphagia evaluation.



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