Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy.
Dysphagia. 2019 Apr;34(2):192-200. doi: 10.1007/s00455-018-9961-0. Epub 2018 Nov 19.
One of the major limitations of the fiberoptic endoscopic evaluation of swallowing (FEES) is related to the challenging application of temporal measures. Among them, Whiteout (WO) is due to pharyngeal and tongue base contraction and might be used as an estimation of the pharyngeal phase duration. The aims of this study were to evaluate the inter- and intrarater reliability of WO duration and to appraise the effects of age, sex, volume, and texture of the boluses on this temporal measurement. A total of 30 healthy volunteers were recruited. According to their age, the subjects were grouped into three different age groups. Each of them underwent FEES examination with different textures (liquid, semisolid, and solid) and volumes. FEES examinations were video recorded, processed with the software Daisy Viewer 2.0, which allowed the acquisition of 25 frames per second (s) and analyzed by three different raters in order to collect data on WO duration. A total of 863 swallowing acts were video recorded. Intra- and interrater reliability of WO duration were excellent. Both volume and bolus's texture significantly affected WO duration. In particular, WO duration was significantly shorter for the liquid texture than for the semisolid and solids ones. In addition, male subjects scored significantly higher values of WO duration. Finally, WO duration was significantly higher in seniors. WO duration seems to be a reliable temporal measure during FEES examination. WO duration seems to be affected by several factors such as age, sex, volume, and consistency.
纤维内镜吞咽功能检查（FEES）的主要局限性之一与时间测量的挑战性应用有关。其中，“全白”（Whiteout，WO）是由于咽和舌基收缩而产生的，可以用作咽期持续时间的估计。本研究的目的是评估 WO 持续时间的组内和组间可靠性，并评估年龄、性别、吞咽物的体积和质地对该时间测量的影响。共招募了 30 名健康志愿者。根据他们的年龄，将受试者分为三个不同的年龄组。他们每个人都接受了不同质地（液体、半固体和固体）和体积的 FEES 检查。FEES 检查被录像，使用 Daisy Viewer 2.0 软件进行处理，该软件允许每秒采集 25 帧，并由三名不同的评估者进行分析，以收集 WO 持续时间的数据。总共记录了 863 次吞咽动作。WO 持续时间的组内和组间可靠性均为优秀。体积和吞咽物质地均显著影响 WO 持续时间。具体来说，液体质地的 WO 持续时间明显短于半固体和固体质地。此外，男性受试者的 WO 持续时间明显更高。最后，老年人的 WO 持续时间明显更高。WO 持续时间似乎是 FEES 检查期间可靠的时间测量指标。WO 持续时间似乎受到年龄、性别、体积和一致性等多种因素的影响。
