Evaluation of a Solid Bolus Suitable for Esophageal Scintigraphy

Abstract

This study was designed to select a suitable solid bolus for esophageal scintigraphy. Optimally, a bolus should leave minimal residual buccal and pharyngeal activity after being swallowed. We compared the oropharyngeal behavior of three boluses, i.e., omelette, egg white, and paté of 1- and 3-ml volume. Thirty patients without dysfunction of the upper esophageal sphincter were recruited for the study. Scintigraphy interpretation was based on the results of condensed images and time activity curves. A total of 108 oropharyngeal transits were analyzed. First we determined the most appropriate volume (1 or 3 ml) of paté, omelette, and egg white (i.e., the volume with the least residual oropharyngeal activity). Buccal or pharyngeal bolus retention occurred significantly less frequently with 1 ml paté than 3 ml (p = 0.03) and also less frequently with 3 ml egg white than with 1 ml egg white (p = 0.03), and the mean buccal bolus retention index was lower using 3 ml omelette than 1 ml omelette (p = 0.03). Then we identified the most suitable of the three selected boluses. Both oral and pharyngeal residues were higher for paté (1 ml) than for omelette (p = 0.02 and 0.05), and pharyngeal residue was significantly lower for omelette (3 ml) than for egg white (3 ml) (p = 0.02). In conclusion, a 3-ml bolus of radiolabeled omelette seems to be the most suitable bolus for exploration of esophageal transit, and its use could enhance the potential of scintigraphy in the assessment of esophageal disorders.

Oral transit time: a critical review of the literature

“…Finally, Baulieu et al 6 in clinical study examined the swallowing of 30 healthy subjects, aged between 21 and 77 years. The gender of the population was not specified.…”

“… 17 , Silva et al 20 , Silva et al 21 , Yoshikawa et al 28 . and Baulieu et al 6 describe the TTO as the time of the oral preparatory phase of swallowing added to the time of the oral procedure in itself. The oral preparatory stage is defined as a food preparation for transportation, which includes incision, chewing and the centralization of bolus in oral cavity.…”

Esophageal introitus (with videos)

“…[1][2] Functional evaluation of the EI can be obtained with videofluoroscopic swallow examination, manometry, scintigraphy, and electromyography. 2,[5][6][7][8] However, a range of normal values remains controversial and their utility uncertain. 2 The manometric evaluation of the upper esophageal sphincter is difficult considering the short zone of interest and the rapid movement with swallowing or any stimulation including that of the catheter.…”

Protocolo fonoaudiológico de introdução e transição da alimentação por via oral para pacientes com risco para disfagia (PITA)

“…O aumento do tempo de trânsito oral está relacionado, na maioria das vezes, a uma fase preparatória-oral inadequada e/ou a um atraso do disparo do reflexo de deglutição (Baulieu et al, 2007;Troche et al, 2008), relacionando-se portanto com as variações de textura dos alimentos (Troche et al, 2008).…”

“…Alguns estudos indicam associação relevante entre a presença de resíduos de alimento em cavidade oral e a disfunção local, ou seja, nas fases preparatória-oral e oral da deglutição (Shaw et al, 2004;Baulieu et al, 2007). Hin et al (2003) (2003).…”