Effect of Age, Sex, Bolus Volume, and Bolus Consistency on Whiteout Duration in Healthy Subjects During FEES

Mozzanica, Francesco; Lorusso, Rosaria; Robotti, Carlo; Zambon, Tania; Corti, Pietro; Pizzorni, Nicole; Vanderwegen, Jan; Schindler, Antonio

doi:10.1007/s00455-018-9961-0

Cited by 23 publications

(22 citation statements)

References 19 publications

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“…The raters also blindly determined the time necessary to perform the 5 dry swallowing acts (total time: TT). TT was timed with a stopwatch in iOS 9.0, 4+ (Tim O's Studios, LLC) at the beginning of the first white-out and at the conclusion of the fifth whiteout 34 . In accordance with the p-score, spontaneous and cued dry swallows were considered.…”

Section: Introductionmentioning

confidence: 99%

Time as a factor during endoscopic assessment of swallowing: relevance in defining the score and severity of swallowing disorders

Farneti

Fattori

Bastiani

2019

Acta Otorhinolaryngol Ital

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Section: Introductionmentioning

confidence: 99%

Time as a factor during endoscopic assessment of swallowing: relevance in defining the score and severity of swallowing disorders

Farneti

Fattori

Bastiani

2019

Acta Otorhinolaryngol Ital

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“…e fact that white-out duration after beginning of LCIG significantly decreased in our study indicates that LCIG improves pharyngeal bradykinesia and thus shortens pharyngeal transit time due to faster pharyngeal movement. White-out duration is one of the most constant parameters in swallowing physiology, and its assessment shows an excellent interrater reliability [20,33]. e beginning of white-out strongly corresponds to the hyoid elevation which defines the beginning of the pharyngeal phase of swallowing [20].…”

Section: Discussionmentioning

confidence: 99%

“…White-out duration is one of the most constant parameters in swallowing physiology, and its assessment shows an excellent interrater reliability [20,33]. e beginning of white-out strongly corresponds to the hyoid elevation which defines the beginning of the pharyngeal phase of swallowing [20]. erefore, white-out duration can be considered as a parameter for pharyngeal transit time [20].…”

Section: Discussionmentioning

confidence: 99%

“…e beginning of white-out strongly corresponds to the hyoid elevation which defines the beginning of the pharyngeal phase of swallowing [20]. erefore, white-out duration can be considered as a parameter for pharyngeal transit time [20]. e average white-out duration in this study before (984 ms) and after (699 ms) the beginning of LCIG was higher compared to the previously published average duration of 675 ms in healthy older subjects (65-74 years) when swallowing solid consistencies [20].…”

Section: Discussionmentioning

confidence: 99%

“…e beginning of the white-out was defined as the first frame in which the laryngeal structures were not visible due to white superimposition. Conversely, the end of the white-out was defined as the first frame in which all laryngeal structures were visible again [19,20].…”

Section: Rating Of Fees Videosmentioning

confidence: 99%

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Effect of Intestinal Levodopa-Carbidopa Infusion on Pharyngeal Dysphagia: Results from a Retrospective Pilot Study in Patients with Parkinson’s Disease

Labeit¹,

Claus

Suntrup‐Krueger³

et al. 2020

Parkinson's Disease

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Background. Pharyngeal dysphagia is a common symptom of Parkinson’s disease (PD) leading to severe complications. PD-related pharyngeal dysphagia (PDrPD) may significantly improve in up to half of patients following acute oral levodopa challenge. Objective. The aim of this study was to investigate the effects of levodopa-carbidopa intestinal gel (LCIG) on PDrPD. Methods. Forty-five PD patients under LCIG treatment were available for retrospective analysis. In all patients with PDrPD who underwent flexible endoscopic evaluation of swallowing (FEES) in the clinical “on-state” both before and after implementation of LCIG treatment, FEES videos were systematically reassessed. PDrPD was characterized using a PD-specific FEES score evaluating premature bolus spillage, penetration/aspiration, and pharyngeal residue. Further, the duration of white-out was assessed, as a parameter for pharyngeal bradykinesia. Results. Eleven patients with PDrPD (mean age 74.6 ± 4.4 years; mean Hoehn and Yahr stage 3.8 ± 0.6) received FEES both before and after the onset of LCIG treatment. The mean swallowing score improved from 14.9 ± 7.3 to 13.0 ± 6.9 after implementation of LCIG; however, this difference was not significant (p=0.312). Premature bolus spillage decreased significantly (p=0.002) from 5.4 ± 1.1 to 3.6 ± 1.0, and white-out duration decreased significantly (p=0.002) from 984 ± 228 ms to 699 ± 131 ms after implementation of LCIG. Conclusions. LCIG may affect PDrPD and reduce premature bolus spillage and pharyngeal bradykinesia. Future studies with larger sample sizes are required to follow-up on these pilot results and identify which factors predict a good response of PDrPD to LCIG treatment.

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Predictors, outcome and characteristics of oropharyngeal dysphagia in idiopathic inflammatory myopathy

Labeit¹,

Perlova²,

Pawlitzki³

et al. 2021

Muscle and Nerve

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Introduction: Oropharyngeal dysphagia is a clinical hallmark of idiopathic inflammatory myopathy (IIM). This study investigated predictors, outcome, and characteristics of oropharyngeal dysphagia in patients with different types of IIM.Methods: Flexible endoscopic evaluation of swallowing (FEES) videos of 71 IIM patients were retrospectively analyzed for bolus spillage, penetration, aspiration, and pharyngeal residue. Based on these findings, dysphagia severity was rated. Regression analyses were performed to investigate demographic and disease-specific predictors of dysphagia severity and pneumonia as outcome-relevant complications of dysphagia. A score was developed to rate the quality of the endoscopic white-out as a surrogate marker for pharyngeal muscle weakness with consecutive residue.Results: Our analysis revealed no independent predictors of dysphagia severity. Dysphagia severity, however, was an independent predictor for pneumonia, which occurred in 24% of patients. Pharyngeal residue with risk of postdeglutitive aspiration was the most common dysphagia pattern. Attenuation of the endoscopic whiteout was related to residue severity. Discussion: Dysphagia in IIM assessed with FEES is associated with relevant complications, such as aspiration pneumonia, and must be considered independently of peripheral muscle weakness and disease duration. Swallowing impairment mainly presents with pharyngeal residue. The quality of the white-out may serve as a semiquantitative surrogate marker for pharyngeal contractility.

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Effect of Age, Sex, Bolus Volume, and Bolus Consistency on Whiteout Duration in Healthy Subjects During FEES

Cited by 23 publications

References 19 publications

Time as a factor during endoscopic assessment of swallowing: relevance in defining the score and severity of swallowing disorders

Time as a factor during endoscopic assessment of swallowing: relevance in defining the score and severity of swallowing disorders

Effect of Intestinal Levodopa-Carbidopa Infusion on Pharyngeal Dysphagia: Results from a Retrospective Pilot Study in Patients with Parkinson’s Disease

Predictors, outcome and characteristics of oropharyngeal dysphagia in idiopathic inflammatory myopathy

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