Auris, nasus, larynx · 2026
Comparison of liquid swallowing kinematics during tablet swallowing with liquid and liquid-only swallowing in patients with dysphagia: A pilot study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Hara Kazuya, Kunieda Kenjiro, Okamoto Keishi, Ohno Tomohisa, Shigematsu Takashi, Fujishima Ichiro
Аннотация
OBJECTIVE: Difficulty swallowing oral medications is associated with an increased risk of liquid aspiration or penetration in patients with dysphagia. However, the underlying mechanism remains unclear. This study aimed to compare the swallowing kinematics during tablet swallowing with liquid and liquid swallowing alone in patients with dysphagia using a videofluoroscopic swallowing study (VFSS). The presence of a tablet was hypothesized to alter swallowing kinematics and delay the initiation of pharyngeal swallowing.
METHODS: In this single-center retrospective study, 40 patients with mild dysphagia (mean age: 70.9±17.6 years; 67.5% with cerebrovascular disease) underwent VFSS. Temporal parameters (oral transit time [OTT], pharyngeal transit time [PTT], pharyngeal delay time [PDT], and laryngeal elevation delay time [LEDT]) were compared between tablet swallowing with thin liquid and swallowing thin liquid alone using the Wilcoxon signed-rank test with Holm's method.
RESULTS: No significant differences were observed in the OTT or PTT. However, tablet swallowing was associated with significantly prolonged PDT and LEDT compared with liquid swallowing alone. During tablet swallowing, 20% of the patients exhibited a penetration-aspiration scale score of ≥ 2, and 10% exhibited silent aspiration, although these events were not statistically associated with prolonged temporal parameters.
CONCLUSION: Compared with liquid alone, swallowing tablets with liquid significantly delayed the initiation of pharyngeal swallowing. Consequently, even patients with mild dysphagia who can safely swallow liquids may be at an increased risk of aspiration, including silent aspiration, when ingesting tablets. These findings highlight the importance of specific assessments for tablet swallowing to ensure safe medication administration.
METHODS: In this single-center retrospective study, 40 patients with mild dysphagia (mean age: 70.9±17.6 years; 67.5% with cerebrovascular disease) underwent VFSS. Temporal parameters (oral transit time [OTT], pharyngeal transit time [PTT], pharyngeal delay time [PDT], and laryngeal elevation delay time [LEDT]) were compared between tablet swallowing with thin liquid and swallowing thin liquid alone using the Wilcoxon signed-rank test with Holm's method.
RESULTS: No significant differences were observed in the OTT or PTT. However, tablet swallowing was associated with significantly prolonged PDT and LEDT compared with liquid swallowing alone. During tablet swallowing, 20% of the patients exhibited a penetration-aspiration scale score of ≥ 2, and 10% exhibited silent aspiration, although these events were not statistically associated with prolonged temporal parameters.
CONCLUSION: Compared with liquid alone, swallowing tablets with liquid significantly delayed the initiation of pharyngeal swallowing. Consequently, even patients with mild dysphagia who can safely swallow liquids may be at an increased risk of aspiration, including silent aspiration, when ingesting tablets. These findings highlight the importance of specific assessments for tablet swallowing to ensure safe medication administration.