Laura Fergusson Trust, Christchurch, New Zealand.
Department of Communication Disorders, The University of Canterbury, Christchurch, New Zealand.
Int J Lang Commun Disord. 2019 May;54(3):444-450. doi: 10.1111/1460-6984.12450. Epub 2019 Jan 21.
The Test of Masticating and Swallowing Solids (TOMASS) has been developed to provide clinicians with objective data regarding the efficiency of oral phase function and solid bolus ingestion.
To determine if the TOMASS will detect changes in the oral phase of swallowing imposed by topical anaesthesia, thus providing validation of its clinical utility.
METHODS & PROCEDURES: Per the standard protocol, 10 healthy participants ate one-quarter of an Arnotts Salada biscuit. The number of bites per cracker, number of masticatory cycles, number of swallows and total time taken were recorded at baseline, following application of topical oral anaesthetic; this was additionally compared with a post-anaesthetic condition. Median and interquartile range (IQR) were calculated. Wilcoxon signed-rank tests were conducted to evaluate trial effect, and Friedman's tests were used to detect differences in the number of bites, number of swallows, number of chews and time taken to eat the crackers.
OUTCOMES & RESULTS: Results indicated that the number of both bites and swallows did not significantly change across conditions (χ²(2) = 0.105, p = 0.949, χ²(2) = 1.357, p = 0.507); however, the number of chews for the anaesthetic condition was significantly higher when compared with the baseline (p = 0.02) and post-anaesthesia conditions (p = 0.02). Further, the durations of ingestion in the anaesthetic condition were significantly longer than the baseline (p = 0.01) and post-anaesthesia (p = 0.01) conditions. Across all measures, there were no differences between baseline and post-anaesthesia conditions.
CONCLUSIONS & IMPLICATIONS: Although further exploration is required, these early data suggest the TOMASS is a sensitive measure in the evaluation of the oral-phase preparation of solid textures.
咀嚼和吞咽固体测试（TOMASS）的开发是为了向临床医生提供有关口腔阶段功能和固体团块摄入效率的客观数据。
确定 TOMASS 是否会检测到局部麻醉对吞咽口腔阶段的影响，从而验证其临床实用性。
按照标准方案，10 名健康参与者吃了四分之一块 Arnotts Salada 饼干。在基线时，记录每个饼干的咬数、咀嚼周期数、吞咽次数和总用时，在应用局部口腔麻醉后记录；这还与麻醉后条件进行了比较。计算中位数和四分位距（IQR）。使用 Wilcoxon 符号秩检验评估试验效果，并使用 Friedman 检验检测咬数、吞咽数、咀嚼数和吃饼干时间的差异。
结果表明，在不同条件下，咬数和吞咽数均无显著变化（χ²(2) = 0.105，p = 0.949，χ²(2) = 1.357，p = 0.507）；然而，与基线（p = 0.02）和麻醉后（p = 0.02）条件相比，麻醉条件下的咀嚼次数显著增加。此外，麻醉条件下的摄入持续时间明显长于基线（p = 0.01）和麻醉后（p = 0.01）条件。在所有测量中，基线和麻醉后条件之间没有差异。
尽管需要进一步探索，但这些早期数据表明 TOMASS 是评估固体质地口腔准备阶段的敏感指标。
