Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University of Jerusalem, Israel.
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University of Jerusalem, Israel; Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikvah, Israel, affiliated with the Tel Aviv University, Tel Aviv, Israel.
Arch Phys Med Rehabil. 2019 Mar;100(3):488-494. doi: 10.1016/j.apmr.2018.05.028. Epub 2018 Jun 27.
To examine the correlation between pharyngeal residue severity and clearance to penetration/aspiration on fiber-optic endoscopic examination of swallowing (FEES).
Retrospective cohort.
Kaplan Medical Center dysphagia clinic.
Patients (N=110) visiting a dysphagia clinic between 2014 and 2016 undergoing FEES.
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.
YPR-SRS and number of clearing swallows were correlated with the PAS of the same bolus challenge.
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.
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.
研究纤维内镜吞咽检查（FEES）中咽残留严重程度与穿透/误吸之间的相关性。
回顾性队列研究。
卡普兰医疗中心吞咽障碍诊所。
2014 年至 2016 年间在吞咽障碍诊所就诊并接受 FEES 检查的患者（N=110）。
使用渗透/误吸渗透误吸量表（PAS）对穿透/误吸进行评分，使用耶鲁咽残留严重程度评分量表（YPR-SRS）对残留严重程度进行评分。记录清除咽部所需的吞咽次数。分析每种一致性（液体、泥状、固体）的第一次和最差的食团挑战。
YPR-SRS 和清除吞咽次数与同一食团挑战的 PAS 相关。
研究人群的平均年龄为 67±13.4 岁；54%为男性（n=58）。在所有测试的一致性、每个解剖部位（ vallecula 或梨状隐窝）以及第一次和最差的食团挑战中，都发现 YPR-SRS 与 PAS 之间存在显著相关性（所有 P<.001）。当 vallecula 和梨状隐窝的评分相加时，残留物与误吸的相关性更强（液体/泥状/固体最差食团挑战的 Pearson 积矩相关系数分别为 0.573/0.631/0.446）。将清除吞咽次数纳入 YPR-SRS 可增强与 PAS 的相关性。
残留严重程度与 FEES 中的穿透/误吸相关。YPR-SRS 可用于标准化 FEES 中残留物的描述，并有助于吞咽障碍评估。
