Mixed Consistencies in Dysphagic Patients: A Myth to Dispel.
Mozzanica Francesco, Pizzorni Nicole, Scarponi Letizia and 3 others
PMID 33598791WHAT IT FOUND
A thin mixed food (biscuits-with-milk) behaved like thin liquid: 11 of 20 had penetration and 4 aspirated.
A thicker mixed food (vegetable soup) behaved like semisolid: 6 had penetration and 2 aspirated. Residue was similar across textures.
Key findings
01Bolus position at swallow onset differed across textures: liquid, biscuits-with-milk and vegetable-soup had higher location scores than semisolid and solid.
02Penetration/aspiration categories differed across textures, with biscuits-with-milk grouping with liquid and vegetable-soup grouping with semisolid and solid.
03Residue scores did not differ significantly across textures in the valleculae or pyriform sinus.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 20 patients were studied, and the authors describe the results as preliminary. The patients had different causes of dysphagia and different swallowing problems, so findings may not apply to one diagnosis. All patients had a full oral diet, usable oral function and a cognitive screening score of 26 or higher, so more impaired patients were not represented. Swallows were cued on command, not normal eating, so everyday meal behaviour may differ. The order of textures was not randomised, so order effects cannot be excluded. FEES did not allow timing measures such as pharyngeal delay time. Intra-rater reliability was not evaluated. The tested mixed foods were specific Italian-style foods (biscuits-with-milk and vegetable soup), delivered mostly by spoon at 10 mL, so other mixed foods or larger portions may behave differently.
Declared interests
The study was funded by Università degli Studi di Milano. No other conflict-of-interest details were reported in the supplied text.
The easy way to misread this
Do not conclude that mixed foods are automatically more dangerous than single foods. In this FEES assessment, biscuits-with-milk behaved like thin liquid, while vegetable soup behaved like semisolid and solid. The study used cued swallows in 20 patients, so it does not show everyday meal safety.