Normative Reference Values for FEES and VASES: Preliminary Data From 39 Nondysphagic, Community-Dwelling Adults.

Purpose: The aim of this study was to establish preliminary reference values for the Visual Analysis of Swallowing Efficiency and Safety (VASES)—a standard- ized rating methodology used to evaluate swallowing safety and efficiency for flexible endoscopic evaluation of swallowing (FEES). Method: FEES...

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Publicado en:Journal of Speech, Language & Hearing Research Vol. 66; no. 7; pp. 2260 - 2278
Autores principales: Curtis, James A., Borders, James C., Dakin, Avery E., Troche, Michelle S.
Formato: Artículo
Publicado: American Speech-Language-Hearing Association Jul2023
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2023
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      pub: American Speech-Language-Hearing Association
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        10.1044/2023_JSLHR-23-00132
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        atl: Normative Reference Values for FEES and VASES: Preliminary Data From 39 Nondysphagic, Community-Dwelling Adults.
      aug:
        au:
          Curtis, James A.
          Borders, James C.
          Dakin, Avery E.
          Troche, Michelle S.
        affil:
          Aerodigestive Innovations Research Lab, Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medical College, New York City, NY.
          Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York City, NY.
      su:
        Therapeutics
        Race
        Adults
        Reference values
        Deglutition
        Speech therapy
        Scientific observation
        Endoscopic surgery
        Health outcome assessment
        Vocal cords
        Epiglottis
        Independent living
        Descriptive statistics
        Hypopharynx
        Research funding
        Statistical sampling
        Endoscopy
        Oropharynx
        Longitudinal method
      sug:
        subj:
          Therapeutics
          Race
          Adults
          Marketing Research and Public Opinion Polling
          Reference values
          Deglutition
          Speech therapy
          Scientific observation
          Endoscopic surgery
          Health outcome assessment
          Vocal cords
          Epiglottis
          Independent living
          Descriptive statistics
          Hypopharynx
          Research funding
          Statistical sampling
          Endoscopy
          Oropharynx
          Longitudinal method
      ab: Purpose: The aim of this study was to establish preliminary reference values for the Visual Analysis of Swallowing Efficiency and Safety (VASES)—a standard- ized rating methodology used to evaluate swallowing safety and efficiency for flexible endoscopic evaluation of swallowing (FEES). Method: FEES were completed in nondysphagic, community-dwelling adults using a standardized protocol of 15 swallowing trials that varied by bolus size, consistency, contrast agent, and swallowing instructions. FEES were blindly analyzed using VASES. Primary outcome measures included bolus location at swallow onset, Penetration–Aspiration Scale (PAS) scores, and percentage- based residue ratings for six anatomic landmarks. Secondary outcome mea- sures included sip size, bite size, and number of swallows. Results: Thirty-nine healthy adults completed the study, yielding an analysis of 584 swallows. Swallows were initiated with the bolus in the pharynx for 41.8% of trials. PAS 1 was the most common score, accounting for 75.3% of trials, followed by PAS 3, which accounted for 18.8% of trials. When residue was present (> 0%), the amount was relatively small across all anatomic landmarks, with median residue ratings of 2.0% (oropharynx), 1.5% (hypopharynx), 3.0% (epiglottis), 3.0% (laryngeal vestibule), and 3.5% (vocal folds). Five events of aspiration were observed, which were characterized by subglottic residue rat- ings of 1%, 3%, 10%, 24%, and 90%. The average sip size of self-selected volume cup sips of water was 19.8 ml, and the average bite size of a 3.0-g sal- tine cracker was 1.33 g. Moreover, 78% of the trials in this study protocol (except 90-ml trials) were completed in a single swallow. Discussion: The results from this study provide preliminary norms for VASES that could be used as a reference when assessing functional swallowing out- comes during FEES. While this is an important first step in establishing norms for FEES and VASES, clinicians and researchers should be mindful that the normative reference values from this study are from a relatively small study sample (N = 39), with most people below the age of 60 years (n = 30). Future research should expand on these norms by including a greater number of people across the age continuum and with greater racial, ethnic, and gender diversity.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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