Association Between Pharyngeal Pooling and Aspiration Using Fiberoptic Endoscopic Evaluation of Swallowing in Head and Neck Cancer Patients with Dysphagia.
Sorina R Simon, Michelle Florie, Walmari Pilz and 4 others
PMID 30868301WHAT IT FOUND
Severe pooling in the pyriform sinuses and valleculae after swallowing thick liquids was linked to aspiration, even when no aspiration was seen during the exam.
Mild-to-moderate pooling showed no such link. These findings suggest pooling severity may help estimate aspiration risk.
Key findings
01Severe postswallow vallecular pooling of thick liquid was significantly associated with aspiration compared to mild-to-moderate pooling, independent of pyriform sinus pooling.
02Severe postswallow pyriform sinus pooling of thick liquid was significantly associated with aspiration compared to no pooling, independent of vallecular pooling.
03Patients who received definitive radiotherapy alone had a significantly higher proportion of aspiration with thin liquid compared to those who received multimodality treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not examine solid food boluses, limiting generalizability to all consistencies. The sample size was too small to analyze detailed group stratifications for tumor stages, locations, or specific treatment combinations. Subjective visuoperceptual assessment of pooling amounts was used, which can be influenced by anatomical changes like edema or fibrosis. FEES provides only a short observation and may not reflect daily swallowing complexities or fatigue-related aspiration risks.
Declared interests
No conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not assume that the absence of observed aspiration during FEES guarantees safety. Severe pooling in the pyriform sinuses or valleculae, especially with thick liquids, was associated with aspiration even when aspiration was not directly visualized during the exam.