Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th Street, Thorndike Building, Room 955, New York, NY, 10027, USA.
Dysphagia. 2021 Apr;36(2):207-215. doi: 10.1007/s00455-020-10131-0. Epub 2020 May 11.
The aim of this study was to assess the effects of color, coating, and opacity on the detection of aspiration, penetration, and residue during flexible endoscopic evaluations of swallowing (FEES). Thirty dysphagic adults underwent FEES while swallowing five 5 mL thin liquid boluses (1 × each, randomized): white water, blue water, white milk, blue milk, and barium water. To assess the effects of color, blue milk was compared to white milk. To assess the effects of coating, barium, white water, and white milk were compared to each other. To assess the effects of opacity, blue milk was compared to blue water. Videos were blindly analyzed and judged for the presence of pharyngeal residue, penetration, and aspiration. Repeated measures analyses were used to assess differences in the frequency of detection across bolus types. Pharyngeal residue was detected more frequently for liquids that were blue, had a coating effect, or were opaque (p < 0.05) when compared to liquids that were white, did not have a coating effect, or were translucent, respectively. Penetration and aspiration were detected more frequently for liquids that had a coating effect (p < 0.05), but not for liquids that were colored blue or opaque (p > 0.05). Coating appears to be the most important factor detecting thin liquid residue, penetration, and aspiration during FEES. Given these findings, standardized use of boluses that possess a coating effect (e.g., white-dyed water or barium) is highly recommended to enhance the sensitivity of identifying impairments in swallowing safety and efficiency during FEES.
本研究旨在评估颜色、涂层和不透明度对吞咽灵活内镜评估（FEES）中吸入、穿透和残留的检测效果。30 名吞咽困难的成年人在吞咽 5 毫升稀薄液体（每种 1 次，随机）时进行了 FEES：白水、蓝水、白奶、蓝奶和钡水。为了评估颜色的影响，将蓝奶与白奶进行了比较。为了评估涂层的影响，将钡、白水和白奶进行了相互比较。为了评估不透明度的影响，将蓝奶与蓝水进行了比较。视频被盲法分析并判断是否存在咽部残留、穿透和吸入。使用重复测量分析来评估不同类型的射流在检测频率上的差异。与白色、无涂层效果或半透明的液体相比，蓝色、具有涂层效果或不透明的液体更容易检测到咽部残留（p<0.05）。具有涂层效果的液体更容易检测到穿透和吸入（p<0.05），而蓝色或不透明的液体则没有（p>0.05）。涂层似乎是在 FEES 中检测稀薄液体残留、穿透和吸入的最重要因素。鉴于这些发现，强烈建议使用具有涂层效果的标准化射流（例如，染色的白水或钡），以提高在 FEES 中识别吞咽安全性和效率受损的敏感性。
