Butler Susan G, Stuart Andrew, Markley Lisa, Feng Xin, Kritchevsky Stephen B
1 Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
2 Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Caroline, USA.
Ann Otol Rhinol Laryngol. 2018 Jan;127(1):21-32. doi: 10.1177/0003489417742161. Epub 2017 Nov 30.
The purpose of this investigation was to examine, via flexible endoscopic evaluation of swallowing (FEES), factors that affect penetration and aspiration during swallowing across the adult lifespan.
Healthy adults (N = 203) across the third to ninth decades of life participated. Penetration Aspiration Scale (PAS) scores were assessed during FEES as a function of age, sex, liquid type (water and skim, 2%, and whole milk), volume (5, 10, 15, and 20 ml), and delivery (cup and straw).
The PAS scores differed significantly by liquid type ( P < .0001) and age group ( P < .0001). In general, PAS scores were higher for milk versus water swallows and for older age groups. Significant interactions of liquid type by age ( P = .0042) and sex by volume ( P = .020) were also evidenced. In addition, the odds of penetration and aspiration increased significantly with milks compared to water and age ( P < .05). Increased bolus volume also increased the odds of aspiration ( P < .05).
Aspiration may be an underappreciated phenomenon in healthy adults. The inclusion of both water and milk test boluses of various volumes during FEES may be important for the appropriate assessment of adult penetration and aspiration.
本研究旨在通过吞咽功能的软性内镜评估（FEES），探讨影响成年人一生中吞咽过程中食物穿透和误吸的因素。
招募了年龄在三十至九十岁之间的203名健康成年人。在FEES检查过程中，根据年龄、性别、液体类型（水、脱脂奶、2%脂肪奶和全脂奶）、体积（5、10、15和20毫升）以及饮用方式（杯子和吸管）评估穿透误吸量表（PAS）得分。
PAS得分在液体类型（P <.0001）和年龄组（P <.0001）上存在显著差异。总体而言，吞咽牛奶时的PAS得分高于吞咽水时的得分，且年龄较大组的得分更高。液体类型与年龄之间（P =.0042）以及性别与体积之间（P =.020）也存在显著交互作用。此外，与水相比，饮用牛奶时穿透和误吸的几率显著增加，且与年龄有关（P <.05）。推注体积增加也会增加误吸几率（P <.05）。
误吸在健康成年人中可能是一个未得到充分重视的现象。在FEES检查期间纳入不同体积的水和牛奶测试推注，对于正确评估成年人的穿透和误吸情况可能很重要。
