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...
| Publicado en: | Journal of Speech, Language & Hearing Research Vol. 66; no. 7; pp. 2260 - 2278 |
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| Autores principales: | , , , |
| Formato: | Artículo |
| Publicado: |
American Speech-Language-Hearing Association
Jul2023
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=164881399&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 164881399 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10924388 1SM jtl: Journal of Speech, Language & Hearing Research issn: 10924388 maglogo: N pubinfo: dt: Jul2023 vid: 66 iid: 7 pid: 42 pub: American Speech-Language-Hearing Association artinfo: ui: 164881399 10.1044/2023_JSLHR-23-00132 ppf: 2260 ppct: 18 formats: fmt: @attributes: type: P size: 1.4MB tig: 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 refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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