Academic literature on the topic 'Penetration-Aspiration Scale'
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Journal articles on the topic "Penetration-Aspiration Scale"
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Rosenbek, John C., Jo Anne Robbins, Ellen B. Roecker, Jame L. Coyle, and Jennifer L. Wood. "A penetration-aspiration scale." Dysphagia 11, no. 2 (1996): 93–98. http://dx.doi.org/10.1007/bf00417897.
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Gaeckle, Maren, Frank Domahs, Angelika Kartmann, Bernd Tomandl, and Ulrike Frank. "Predictors of Penetration-Aspiration in Parkinson’s Disease Patients With Dysphagia: A Retrospective Analysis." Annals of Otology, Rhinology & Laryngology 128, no. 8 (2019): 728–35. http://dx.doi.org/10.1177/0003489419841398.
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Objective:Penetration-aspiration is considered the most severe sign of dysphagia, with aspiration pneumonia as one of its consequences. More than half of Parkinson’s disease (PD) patients suffer from dysphagia, and aspiration pneumonia is among the primary causes of mortality in PD patients. However, the identification of predictors of penetration-aspiration in PD patients remains an understudied topic. The purpose of this study was to identify predictors of penetration-aspiration in patients with PD.Methods:The data of 89 PD patients with dysphagia who underwent routinely conducted videofluoroscopic studies of swallowing (VFSS) were included in this retrospective study. The occurrence of penetration-aspiration was defined as scores ≥3 on the Penetration-Aspiration Scale (PAS). Four commonly reported signs of dysphagia in PD patients were evaluated as possible predictors. Furthermore, the relationships between the occurrence of penetration-aspiration and liquid bolus volume as well as clinical severity of PD (modified Hoehn and Yahr scale) were examined.Results:Logistic regression showed that a delayed initiation of the pharyngeal swallow (odds ratio [OR] = 7.47, P = .008) and a reduced hyolaryngeal excursion (OR = 5.13, P = .012) were predictors of penetration-aspiration. Moreover, there was a strong, positive correlation between increasing liquid bolus volume and penetration-aspiration (γ = 0.71, P < .001). No correlation was found between severity of PD and penetration-aspiration (γ = 0.077, P = .783).Conclusion:Results of the present study allow for a better understanding of penetration-aspiration risk in PD patients. They are useful for treatment planning in order to improve safe oral intake and adequate nutrition.
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Hanna, R., and D. R. Randall. "Progression of swallowing dysfunction and associated complications of dysphagia in a cohort of patients with serial videofluoroscopic swallow examinations." Journal of Laryngology & Otology 135, no. 7 (2021): 593–98. http://dx.doi.org/10.1017/s0022215121001298.
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AbstractObjectiveDysphagia is a common symptom with associated complications ranging from mild discomfort to life-threatening pulmonary compromise. Videofluoroscopic swallow is the ‘gold standard’ evaluation for oropharyngeal dysphagia, but little is known about how patients’ performance changes over time.MethodThis was a retrospective cohort study evaluating dysphagia patients’ clinical course by serial videofluoroscopic swallow study. Univariate analysis followed by multivariate analysis were used to identify correlations between pneumonia outcomes, diet allocation, aetiology and comorbidities.ResultsThis study identified 104 patients (53 per cent male) stratified into risk groups by penetration-aspiration scale scores. Mean penetration-aspiration scale worsened over time (p < 0.05), but development of pneumonia was not associated with worsened penetration-aspiration scale score over time (p = 0.57) or severity of dysphagia (p = 0.88).ConclusionOur dataset identified a large cohort of patients with oropharyngeal dysphagia and demonstrated mean penetration-aspiration scale tendency to worsen. Identifying prognostic factors associated with worsening radiological findings and applying this to patients at risk of clinical swallowing difficulty is needed.
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Wick, Elizabeth H., Kaalan Johnson, Kim Demarre, Amy Faherty, Sanjay Parikh, and David L. Horn. "Reliability and Construct Validity of the Penetration-Aspiration Scale for Quantifying Pediatric Outcomes after Interarytenoid Augmentation." Otolaryngology–Head and Neck Surgery 161, no. 5 (2019): 862–69. http://dx.doi.org/10.1177/0194599819856299.
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Objective To assess the reliability and construct validity of the Penetration-Aspiration Scale in children. Study Design This was a retrospective cohort study of pre- and postoperative video modified barium swallow studies from children who underwent interarytenoid injection augmentation for unexplained persistent pharyngeal dysphagia. Two pediatric speech and language pathologists reviewed each study twice in a blinded and randomized fashion. Setting Tertiary academic pediatric hospital. Subjects and Methods Thirty children were identified with adequate pre- and postoperative modified barium swallow studies within 4 weeks of intervention. Children were separated into clinical outcome groups based on ability to advance to thinner diet consistencies postoperatively. Construct validity was assessed with a mixed linear model to test the hypothesis that only the clinically improved group would receive better Penetration-Aspiration Scale scores after surgery. Reliability was assessed by calculating chance-corrected agreement between raters (interrater) and raters’ repeat evaluations (intrarater). Results Inter- and intrarater reliabilities (Cohen’s κ) were both excellent. Results of the mixed model revealed a significant interaction between outcome group and pre- and postoperative time interval. As hypothesized, this involved a significant improvement in Penetration-Aspiration Scale score only in the improved group. Conclusions These findings suggest that the Penetration-Aspiration Scale is a reliable and valid measure of clinical response to interarytenoid injection augmentation in children.
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Zuniga, Steven A., Barbara Ebersole, and Nausheen Jamal. "Utility of Eating Assessment Tool–10 in Predicting Aspiration in Patients with Unilateral Vocal Fold Paralysis." Otolaryngology–Head and Neck Surgery 159, no. 1 (2018): 92–96. http://dx.doi.org/10.1177/0194599818762328.
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Objective Examine the incidence of penetration/aspiration in patients with unilateral vocal fold immobility and investigate the relationship with self-reported perception of dysphagia. Study Design Case series with chart review. Setting Academic cancer center. Subjects and Methods Adult patients with unilateral vocal fold immobility diagnosed between 2014 and 2016 were reviewed. Patients were stratified into an aspiration group and a nonaspiration group using objective findings on flexible endoscopic evaluation of swallowing, as scored using Rosenbek’s Penetration Aspiration Scale. Objective findings were compared to patient perception of dysphagia. Bivariate linear correlation analysis was performed to evaluate correlation between Eating Assessment Tool–10 scores and presence of aspiration. Tests of diagnostic accuracy were calculated to investigate the predictive value of Eating Assessment Tool–10 scores >9 on aspiration risk. Results Of the 35 patients with new-onset unilateral vocal fold immobility were evaluated, 25.7% (9/35) demonstrated tracheal aspiration. Mean ± SD Eating Assessment Tool–10 scores were 19.2 ± 13.7 for aspirators and 7.0 ± 7.8 for nonaspirators ( P = .016). A statistically significant correlation was demonstrated between increasing Eating Assessment Tool–10 scores and Penetration Aspiration Scale scores ( r = 0.511, P = .002). Diagnostic accuracy analysis for aspiration risk in patients with an Eating Assessment Tool–10 score >9 revealed a sensitivity of 77.8% and a specificity of 73.1%. Conclusion Patient perception of swallowing difficulty may have utility in predicting aspiration risk. An EAT–10 of >9 in patients with unilateral vocal fold immobility may portend up to a 5 times greater risk of aspiration. Routine swallow testing to assess for penetration/aspiration may be indicated in patients with unilateral vocal fold immobility.
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Mancopes, Renata, Bruna Franciele da Trindade Gonçalves, Cintia Conceição Costa, et al. "Correlation between the reason for referral, clinical, and objective assessment of the risk for dysphagia." CoDAS 26, no. 6 (2014): 471–75. http://dx.doi.org/10.1590/2317-1782/20142014065.
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PURPOSE: To correlate the reason for referral to speech therapy service at a university hospital with the results of clinical and objective assessment of risk for dysphagia. METHODS: This is a cross-sectional, observational, retrospective analytical and quantitative study. The data were gathered from the database, and the information used was the reason for referral to speech therapy service, results of clinical assessment of the risk for dysphagia, and also from swallowing videofluoroscopy. RESULTS: There was a mean difference between the variables of the reason for the referral, results of the clinical and objective swallowing assessments, and scale of penetration/aspiration, although the values were not statistically significant. Statistically significant correlation was observed between clinical and objective assessments and the penetration scale, with the largest occurring between the results of objective assessment and penetration scale. CONCLUSION: There was a correlation between clinical and objective assessments of swallowing and mean difference between the variables of the reason for the referral with their respective assessment. This shows the importance of the association between the data of patient's history and results of clinical evaluation and complementary tests, such as videofluoroscopy, for correct identification of the swallowing disorders, being important to combine the use of severity scales of penetration/aspiration for diagnosis.
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Holman, Shaina Devi, Regina Campbell-Malone, Peng Ding, et al. "Development, Reliability, and Validation of an Infant Mammalian Penetration–Aspiration Scale." Dysphagia 28, no. 2 (2012): 178–87. http://dx.doi.org/10.1007/s00455-012-9427-8.
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Steele, Catriona M., and Karen Grace-Martin. "Reflections on Clinical and Statistical Use of the Penetration-Aspiration Scale." Dysphagia 32, no. 5 (2017): 601–16. http://dx.doi.org/10.1007/s00455-017-9809-z.
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Mirzakhani, Hooman, June-Noelle Williams, Jennifer Mello, et al. "Muscle Weakness Predicts Pharyngeal Dysfunction and Symptomatic Aspiration in Long-term Ventilated Patients." Anesthesiology 119, no. 2 (2013): 389–97. http://dx.doi.org/10.1097/aln.0b013e31829373fe.
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Abstract Background: Prolonged mechanical ventilation is associated with muscle weakness, pharyngeal dysfunction, and symptomatic aspiration. The authors hypothesized that muscle strength measurements can be used to predict pharyngeal dysfunction (endoscopic evaluation–primary hypothesis), as well as symptomatic aspiration occurring during a 3-month follow-up period. Methods: Thirty long-term ventilated patients admitted in two intensive care units at Massachusetts General Hospital were included. The authors conducted a fiberoptic endoscopic evaluation of swallowing and measured muscle strength using medical research council score within 24 h of each fiberoptic endoscopic evaluation of swallowing. A medical research council score less than 48 was considered clinically meaningful muscle weakness. A retrospective chart review was conducted to identify symptomatic aspiration events. Results: Muscle weakness predicted pharyngeal dysfunction, defined as either valleculae and pyriform sinus residue scale of more than 1, or penetration aspiration scale of more than 1. Area under the curve of the receiver-operating curves for muscle strength (medical research council score) to predict pharyngeal, valleculae, and pyriform sinus residue scale of more than 1, penetration aspiration scale of more than 1, and symptomatic aspiration were 0.77 (95% CI, 0.63–0.97; P = 0.012), 0.79 (95% CI, 0.56–1; P = 0.02), and 0.74 (95% CI, 0.56–0.93; P = 0.02), respectively. Seventy percent of patients with muscle weakness showed symptomatic aspiration events. Muscle weakness was associated with an almost 10-fold increase in the symptomatic aspiration risk (odds ratio = 9.8; 95% CI, 1.6–60; P = 0.009). Conclusion: In critically ill patients, muscle weakness is an independent predictor of pharyngeal dysfunction and symptomatic aspiration. Manual muscle strength testing may help identify patients at risk of symptomatic aspiration.
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Pisegna, Jessica M., Susan E. Langmore, Tanya K. Meyer, and Barbara Pauloski. "Swallowing Patterns in the HNC Population: Timing of Penetration-Aspiration Events and Residue." Otolaryngology–Head and Neck Surgery 163, no. 6 (2020): 1232–39. http://dx.doi.org/10.1177/0194599820933883.
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Objective This study described swallowing patterns in a large head/neck cancer (HNC) cohort. Study Design In a retrospective review of data from a randomized controlled trial, we studied timing of penetration events as they related to aspiration and oral/pharyngeal residue. Setting Retrospective review of a multicenter randomized controlled trial. Subjects and Methods In total, 168 patients who were >3 months postradiation received baseline modified barium swallow evaluations. Retrospective analyses of data from these exams were studied, including Penetration-Aspiration Scale (PAS) scores and timing of these events (before, during, or after the swallow), as well as percentage of oral and pharyngeal residue. Results Aspiration occurred more frequently after than before or during the swallow ( P < .05). There were significantly more events of penetration that led to aspiration after the swallow (n = 260) when compared to events before (n = 6) or after (n = 81) the swallow. There was more pharyngeal (16%-25%) than oral residue (5%-20%). Weak correlations were found between thin liquid, nectar-thick liquid, pudding residue, and PAS scores, with varying significance (pharyngeal residue/PAS rs: .26*, .35*, .07*; oral residue/PAS rs: .21*, .16, .3; * P < .05). Conclusion The predominant pattern for this sample of postradiation patients with HNC with dysphagia was aspiration that occurred after the swallow, rather than before or during the swallow. The aspiration was directly caused by penetration events that occurred during the swallow, resulting in aspiration as the airway reopened. Patients demonstrated more pharyngeal residue than oral residue, but a weak relationship was found between residue and penetration/aspiration events. These results guide clinicians in targeting appropriate swallowing interventions.
Dissertations / Theses on the topic "Penetration-Aspiration Scale"
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Trent, Allison L. "Penetration-Aspiration Scale for Different Bolus Consistencies in Poststroke Patients." Ohio University Honors Tutorial College / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ouhonors1275613394.
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McFarlane, Mary. "A Pilot Study of Change in Laryngeal Cough Threshold Sensitivity and PAS(Penetration Aspiration Scale) Score Within the Acute Stage." Thesis, University of Canterbury. Speech and language science, 2013. http://hdl.handle.net/10092/10734.
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Background: Cough Reflex Testing (CRT) has been shown to be useful in the challenging task of
identifying silent aspiration (aspiration without a cough response). With the emergence of the routine
clinical use of CRT in the acute stroke population, the following clinical conundrum often arises:
Does passing a previously failed CRT mean the risk of silent aspiration has resolved? The purpose of
this study was to evaluate the association between change in laryngeal cough threshold sensitivity and
change in PAS (Penetration Aspiration Scale) score within the acute stage post-stroke. Methods: This was a prospective longitudinal pilot study of 20 acute stroke patients utilizing a
Cough Reflex Threshold Test (CRTT) at 0.4M, 0.6M and 0.8M citric acid concentrations and
Fiberoptic Endoscopic Evaluation of Swallowing (FEES). A cough response threshold was obtained
from the CRTT and a PAS (penetration aspiration scale) score from FEES. Inclusion criteria required
a PAS score of 4 or above on preliminary FEES or impaired CRT threshold as defined by weak or
failed cough test result at 0.8M citric acid concentration. Both test methods were repeated every four
days for 20 days or until the participant no longer aspirated/penetrated and had a normal result on
CRTT on two consecutive assessment sessions. Agreement between changes in the two tests was
evaluated using the Cohen’s Kappa statistic.
Results: Eighteen of the twenty participants in this study aspirated on initial assessment, ten of which
were silent. One participant continued to aspirate at study completion. On initial assessment eleven
participants had a C2 response threshold at 0.4M citric acid concentration and three participants failed
to reach threshold at 0.8M citric acid concentration. At study completion, 18 participants had a C2
response threshold at 0.4M citric acid concentration and one participant failed to reach threshold at
0.8M citric acid concentration. During the study, sixty-six re-assessments took place; there were
fifteen incidences of improved cough response threshold on re-assessment and thirty-one incidences
of improved PAS score. There was no significant agreement between improved laryngeal cough reflex threshold and improved PAS score during the acute stage Kappa = 0.0598 (p <.0.574), 95% CI (-
0.1496- 0.2692).
Conclusion: Significant limitations of this study included small data set and potential flooring effect
of the CRT. Due to the limitations of this study, no conclusions can be made as to the appropriateness
of reinstating oral intake based on passing a previously failed CRT.
Book chapters on the topic "Penetration-Aspiration Scale"
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I. Ershov, Vadim. "Dysphagia Associated with Neurological Disorders." In Therapy Approaches in Neurological Disorders. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96165.
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Neurogenic dysphagia is characterized by problems with neural control of swallowing caused by various neurological diseases: vascular diseases, traumatic diseases, neoplasms, infections, neuromuscular diseases, and others. In patients of intensive care units after long-term intubation and extubation may evolve “postextubation dysphagia”, characterized by the “learned non-use” phenomenon. Neurogenic dysphagia is a component of bulbar or pseudobulbar palsy, depending on the level of the neurological lesion. Diagnoses of neurogenic dysphagia include clinical examination (water swallow test), videofluoroscopy, upper gastrointestinal tract endoscopy and manometry, fiberoptic endoscopic evaluation of swallowing, a grade of Penetration-Aspiration Scale, and Fiberoptic Endoscopic Dysphagia Severity Scale. Dysphagia complications (malnutrition, dehydration, weight loss, aspiration, and respiratory tract obstruction) associated with bad functional recovery and life prognosis, so neurogenic dysphagia need a complex treatment: correct feeding pattern of caloric value and consistency, methods of oral cavity mucosa sensitivity stimulation, swallowing process stimulation, physiotherapeutic treatment methods (electrical stimulation of the larynx and tongue root), logopedic exercises therapy, surgical correction, lifestyle correction, and others. Sometimes it is a need for replacement therapy method by nasogastric tube and percutaneous endoscopic gastrostomy, parenteral feeding in several cases. Neurogenic dysphagia patient rehabilitation includes the “swallowing enhancement” method with optimal food consistency and training method after correct preparation of the oral cavity for swallowing. Neurogenic dysphagia patient oral feeding requires correct technique and contact with the patient for safety and efficient recovery.