Accumulated Secretions and Associated Aerodigestive Function in Patients With Dysphagia.

Purpose: Accumulated pharyngo-laryngeal secretions are associated with dysphagia, aspiration, and poor health outcomes. Despite ongoing developments in the evaluation of pharyngo-laryngeal secretions, understanding of the underlying mechanisms is limited. Pathophysiology associated with accumulated secretions is needed to guide tailored, targeted treatment pathways.

Pharyngeal Squeeze Maneuver During Endoscopy-What Does it Tell Us?

Objectives: Diminished pharyngeal constriction is a common biomechanical deficit associated with dysphagia and holds strong predictive value for aspiration. Pharyngeal squeeze manoeuvre (PSM) was previously validated for evaluating pharyngeal constriction on endoscopy. However, PSM is not routinely used in laryngology clinics or flexible endoscopic evaluation of swallowing (FEES) protocols worldwide.

Current approaches to reporting pharyngo-laryngeal secretions.

Purpose Of Review: Accumulated secretions in the pharynx and larynx are associated with dysphagia, aspiration and pneumonia, as well as increased social, health and economic burden. This article reviews developments in the instrumental reporting of pharyngo-laryngeal secretions over the last 2 years.

Recent Findings: Although the healthy pharynx and larynx is moist, accumulation of secretions is indicative of abnormality.

Development, intra- and inter-rater reliability of the New Zealand Secretion Scale (NZSS).

: The New Zealand Secretion Scale (NZSS) has been developed for comprehensive assessment of accumulated secretions during endoscopy. The scale rates secretion severity under the subcategories location, amount and response. This study describes the scale's development and reliability when used by experts and untrained raters.

Cough response to aspiration in thin and thick fluids during FEES in hospitalized inpatients.

Background: The modifications of fluid viscosity and/or volume are common strategies in dysphagia management, with increased viscosity or reduced volume intended to reduce aspiration. Little attention has been given to whether cough response to aspiration varies across different viscosities and volumes.

Aims: This prospective observational study investigated aspiration prevalence and cough response to aspiration in thin and thick fluids of two different volumes in patients referred for flexible endoscopic evaluation of swallowing (FEES) in an acute hospital setting.