A Method to Objectively Assess Swallow Function in Adults With Suspected Aspiration
Open accessAbstract
Background & aims Pharyngeal manometry and impedance provide information on swallow function. We developed a new analysis approach for assessment of aspiration risk.Methods We studied 20 patients (30-95 years old) with suspected aspiration who were referred for videofluoroscopy, along with controls (ages 24-47 years). The pharyngeal phase of liquid bolus swallowing was recorded with manometry and impedance. Data from the first swallow of a bolus and subsequent clearing swallows were analyzed. We scored fluoroscopic evidence of aspiration and investigated a range of computationally derived functional variables. Of these, 4 stood out as having high diagnostic value: peak pressure (PeakP), pressure at nadir impedance (PNadImp), time from nadir impedance to peak pressure (TNadImp-PeakP), and the interval of impedance drop in the distal pharynx (flow interval).Results During 54 liquid, first swallows and 40 clearing swallows, aspiration was observed in 35 (13 patients). Compared to those of controls, patient swallows were characterized by a lower PeakP, higher PNadImp, longer flow interval, and shorter TNadImp-PeakP. A Swallow Risk Index (SRI), designed to identify dysfunctions associated with aspiration, was developed from iterative evaluations of variables. The average first swallow SRI correlated with the average aspiration score (r = 0.846, P < .00001 for Spearman Rank Correlation). An average SRI of 15, when used as a cutoff, predicted aspiration during fluoroscopy for this cohort (κ = 1.0).Conclusions Pressure-flow variables derived from automated analysis of combined manometric/impedance measurements provide valuable diagnostic information. When combined into an SRI, these measurements are a robust predictor of aspiration.
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The lower penetration-aspiration accuracy in this study may be due to the absence of impedance measurement, which is useful for detecting bolus residue.
“This disparity may be due to the absence of impedance measurement, which is useful for detecting bolus residue.6”
From Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition (2013) · cites this paper as [6]
While impedance may not reliably measure pharyngeal bolus transit time, it can provide information on the presence or absence of pharyngeal bolus residue.
“While impedance may not reliably measure pharyngeal bolus transit time,5 it can provide information on the presence or absence of pharyngeal bolus residue.7-8”
From Artificial neural network classification of pharyngeal high‐resolution manometry with impedance data (2013) · cites this paper as [7]
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Self-citation
- Authors
- Omari, T. I., Dejaeger, E., van Beckevoort, D., Goeleven, A., Davidson, G. P., Dent, J., Tack, J., & Rommel, N.
- Affiliations
- Women's and Children's Health Network (AU)
- Universitair Ziekenhuis Leuven (BE)
- Royal Adelaide Hospital (AU)
- Corresponding author
- Omari, Taher I.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 140
- Issue
- 5
- Pages
- 1454-1463
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2061971154
- Cited by
- 142
- References
- 21
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 8 · 2019: 14 · 2018: 15 · 2017: 11 · 2016: 11 · 2015: 11 · 2014: 13 · 2013: 12 · 2012: 17
- FWCI
- 36.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Keywords
- aspiration, dysphagia, pharyngeal manometry, impedance, pharyngeal pressure, pressure-flow study
- MeSH terms
- Adult, Aged, Aged, 80 and over, Deglutition, Deglutition Disorders, Female, Fluoroscopy, Humans, Male, Manometry, Middle Aged, Pharynx, Pressure, Video Recording, Reproducibility of Results, Young Adult
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