SLPSystematic ReviewDysphagia2025

Upper Airway Sensory Testing in Dysphagia - Implications for Clinical Practice and Future Research Directions.

Norita Regio, Ruby Hutton, Emma S Wallace

PMID 39625497

WHAT IT FOUND

The review found no standard way to test upper airway sensation in swallowing.

FEESST and cough reflex tests were most common, but stimuli and normal criteria varied widely. Gag reflex testing is unreliable because many healthy people lack it. Taste testing is cheap but also lacks standard methods.

Key findings

01Four main sensory tests were identified: FEESST, cough reflex testing, gag reflex testing, and taste testing.

02FEESST methods varied significantly in stimulus type, pressure, and normal criteria, with many studies not reporting pressures.

03Gag reflex testing is limited because up to 75% of people, especially the elderly, have an absent gag response.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The review only included English-language studies. It excluded children and healthy individuals, so findings do not apply to those groups. The review did not assess the quality or risk of bias of the included studies, only their methods. Many included studies were cross-sectional or case series, which limits the strength of evidence regarding clinical utility.

Declared interests

No conflicts of interest or funding sources were declared in the provided text.

The easy way to misread this

Do not assume that a sensory test result from one clinic is directly comparable to another. The review found that stimuli, pressures, and normal criteria vary widely between studies, so a 'normal' or 'abnormal' label depends entirely on the specific method used.

Read it on PubMed →