Abstract
【Objectives】Various approaches for removing residual food on the pharynx in patients with dysphagia or eating dysfunction have been attempted in the clinical setting to reduce the risk of choking, aspiration pneumonia, and associated problems. However, few studies have confirmed the effectiveness of such approaches. The present study was conducted to investigate the effectiveness of alternate swallowing of a jelly food (Engelead® Apple Jelly) for removing residual food on the pharynx. Alternate swallowing was evaluated by videofluoroscopic swallowing study.
【Subjects and Methods】The subjects were patients with dysphagia or eating difficulties who were found to have residual food on the pharynx after they had consumed at least one of three barium-based test foods with different viscosities (viscosity similar to honey, yogurt, or liquid) and who performed alternate swallowing of the jelly food. The effectiveness of alternate swallowing for removing residual food on the pharynx was evaluated by measuring the amount of the test food remaining in the epiglottic vallecula and piriform sinus before and after the consumption of the jelly food, with the results scored using a 4-grade scale (a large amount, a small amount, surface adhesion, and no residual food).
【Results】The study included 28 subjects (average age: 73.2 years; primary medical condition: 15 patients with cerebral infarction, 7 with cerebral hemorrhage, 4 with aspiration pneumonia, and 2 with other conditions). One patient was dropped from the study because continued aspiration from the piriform sinus was observed due to the retention of large quantities of the consumed food. After alternate swallowing of the jelly food, the residual food score for the epiglottic vallecula was improved in 60%-72% of the patients and that for the piriform sinus was improved in 75%-100% of the patients, with a significant difference observed by the Wilcoxon signed-rank test. Adverse events such as coughing, hoarseness, decreased oxygen saturation, and fever were not observed, and no clinical problems were noted in any of the patients.
【Discussion】The alternate swallowing of Engelead® Apple Jelly was found to be effetctive for removing residual food in the epiglottic vallecula and piriform sinus for all three test foods with different viscosities. These results indicate that the alternate swallowing of the jelly food is an effective method for reducing the risk of retention of food on the pharynx in dysphagia patients.
