Brady Susan L, Wesling Michele W, Donzelli Joseph J, Kaszuba Scott
Corresponding author: Susan Brady, MS, CCC-SLP, Department of Research and Outcomes, Marianjoy Rehabilitation Hospital, 26 W. 171 Roosevelt Rd., Wheaton, IL 60187. Email:
Ear Nose Throat J. 2016 Feb;95(2):E7-10. doi: 10.1177/014556131609500203.
We conducted a prospective, descriptive study of 27 individuals with known or suspected dysphagia to investigate the relationship between swallowing frequency, accumulated oropharyngeal secretion levels, and gustatory stimulation. Assessment of the secretion level was quantified with the use of a previously published 5-point rating scale using endoscopy. Overall, we found a moderate relationship between the baseline swallowing frequency at rest and the accumulated oropharyngeal secretion level (Pearson correlation 0.470; p = 0.01). The study sample was divided into two groups based on their secretion level. Group 1 (n = 19; mean age 59.7 ± 21.5 years) included patients whose accumulated oropharyngeal secretion level was rated as 1 (normal) or 2 (mild). Group 2 (n = 8; mean age 69.78 ± 8.35 years) included patients whose accumulated oropharyngeal secretion level was rated as 4 (severe) or 5 (profound). For Group 1, swallowing frequency increased from a baseline of 1.05 to 5.26 swallows over 2 minutes, following gustatory stimulation; for Group 2 it increased from a baseline of 0.125 swallows to 3.5 swallows. These results indicate that individuals with a lower baseline swallowing frequency at rest demonstrated a higher accumulated oropharyngeal secretion level as viewed by nasal endoscopy and that, regardless of secretion level, gustatory stimulation was effective at increasing swallowing frequency. Increasing swallowing frequency may be a functional dysphagia treatment objective in efforts to improve the efficiency of the swallow and may offer better management of accumulated oropharyngeal secretions.
我们对27名已知或疑似吞咽困难的个体进行了一项前瞻性描述性研究，以调查吞咽频率、口咽分泌物累积水平和味觉刺激之间的关系。使用先前发表的5分内镜评分量表对分泌物水平进行量化评估。总体而言，我们发现静息时的基线吞咽频率与口咽分泌物累积水平之间存在中度相关性（Pearson相关系数为0.470；p = 0.01）。根据分泌物水平将研究样本分为两组。第1组（n = 19；平均年龄59.7 ± 21.5岁）包括口咽分泌物累积水平被评为1（正常）或2（轻度）的患者。第2组（n = 8；平均年龄69.78 ± 8.35岁）包括口咽分泌物累积水平被评为4（重度）或5（极重度）的患者。对于第1组，味觉刺激后，吞咽频率在2分钟内从基线的1.05次吞咽增加到5.26次吞咽；对于第2组，吞咽频率从基线的0.125次吞咽增加到3.5次吞咽。这些结果表明，通过鼻内镜观察，静息时基线吞咽频率较低的个体口咽分泌物累积水平较高，并且无论分泌物水平如何，味觉刺激均能有效增加吞咽频率。增加吞咽频率可能是功能性吞咽困难治疗的一个目标，旨在提高吞咽效率，并可能更好地管理口咽分泌物的积聚情况。
