Relationship between Different Food Properties and Aspiration/ Pharyngeal Residue in Patients with Neuromuscular Diseases

Abstract

　Objective:　This study aimed to investigate the relationship between aspiration and pharyngeal residue from the differences in physical properties of jellies and thickened liquids administered to patients with neuromuscular diseases.

　Methods:　Patients with neuromuscular diseases who underwent videofluoroscopic examination of swallowing (VF) were retrospectively surveyed from medical records. Observing the lateral view of VF, we used four different jelly diets: jellies of 5,000 N/m² and 8,500 N/m² firmness respectively, a lightly thickened jelly (viscosity 116.6 mPa・s), and an intermediately thickened jelly (viscosity 276.8 mPa・s). The presence or absence of aspiration and pharyngeal residue was investigated. For statistical analysis, the chisquared (χ²) test and Fisher's exact test were used to compare aspiration and pharyngeal residue for each property. In addition, Student's t-test was used to compare age and BMI, with and without aspiration and pharyngeal residue.

　Results:　Sixty-five subjects (28 men and 37 women) who underwent VF during the study were included in the analysis. No significant differences were observed in aspiration between the physical properties. Residues in the epiglottic fossa were significantly less with the lightly thickened jelly than the 5,000 N/m² jelly (p＜0.05) compared to the 8,500 N/m² jelly, residues were significantly less with the intermediately and lightly thickened jellies (p＜0.05 and p＜0.01, respectively). The residues in the piriform fossa were significantly less with the lightly thickened jelly than the 5,000 N/m² jelly (p＜0.05); however, there were no differences among other properties.

　Conclusion:　We investigated the relationship between aspiration and pharyngeal residue in patients with neuromuscular diseases and suggest that a low-viscosity liquid may be appropriate due to the presence of less pharyngeal residue.