Abstract
Objectives
To examine the correlation between pharyngeal residue severity and clearance to penetration/aspiration
on fiber-optic endoscopic examination of swallowing (FEES).
Design
Retrospective cohort.
Setting
Kaplan Medical Center dysphagia clinic.
Participants
Patients (N=110) visiting a dysphagia clinic between 2014 and 2016 undergoing FEES.
Interventions
FEES 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 challenges for each consistency (liquid, purée, solid) were
analyzed.
Main Outcome Measures
YPR-SRS and number of clearing swallows were correlated with the PAS of the same bolus
challenge.
Results
The study population’s mean age was 67±13.4 years; 54% were men (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 challenges (P<.001 for all). The correlation of residue with aspiration was stronger when vallecula
and pyriform sinuses scores were summated (Pearson product-moment 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.
Conclusions
Residue 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.
Keywords
List of abbreviations:
BRACS (Boston Residue and Clearance Scale), FEES (fiber-optic endoscopic examination of swallowing), PAS (Penetration Aspiration Scale), PCC (Pearson product-moment correlation coefficient), YPR-SRS (Yale Pharyngeal Residue Severity Rating Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 27, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
