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The effects of endoscope placement in the hypopharynx on swallowing-related measures in healthy adults

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to determine whether transnasal passage of a flexible endoscope results in changes in salivary flow rate (SFR), spontaneous swallow frequency (SSF), and masticatory efficiency (ME) in healthy adults.

Methods

Data were collected from 15 healthy adults, 20–63 years of age. SFR and SSF were measured at baseline, after endoscope insertion, and after endoscope removal. The Test of Masticating and Swallowing Solids was administered at baseline and while the endoscope was in the hypopharynx. A repeated measures ANOVA was used to determine the effect of endoscope insertion on SFR and SSF. A paired samples t-test was used to determine the effect of endoscope insertion on total mastication time and number of masticatory cycles required with a cracker bolus. Statistical significance was set at α = 0.05.

Results

SFR was found to be significantly increased during endoscope placement in the hypopharynx (M = 0.471 g/min, SD = 0.175, p = 0.002) as well as following endoscope removal (M = 0.481 g/min, SD = 0.231, p = 0.004), as compared to baseline (M = 0.310 g/min, SD = 0.130). Total mastication time and number of masticatory cycles required with a cracker bolus were significantly decreased when the endoscope was present in the hypopharynx, as compared to baseline t(14) = 3.054, p = 0.009; t(14) = 3.250, p = 0.006, respectively.

Conclusions

Visualization of swallowing during FEES is an important method for objectively evaluating several anatomical and functional parameters of the pharynx and larynx. Insertion of the endoscope into the hypopharynx during FEES may stimulate salivary secretion and improve ME, which could influence interpretation of FEES and resulting clinical recommendations.

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Data availability

Data are available upon request from the corresponding author.

References

  1. Dawes C, Pedersen AML, Villa A, Ekström J, Proctor GB, Vissink A, Aframian D, McGowan R, Aliko A, Narayana N, Sia YW, Joshi RK, Jensen SB, Kerr AR, Wolff A (2015) The functions of human saliva: a review sponsored by the world workshop on oral medicine VI. Arch Oral Biol 60:863–874. https://doi.org/10.1016/j.archoralbio.2015.03.004

    Article  CAS  PubMed  Google Scholar 

  2. Edgar M, Dawes C, Saliva DO (2012) Saliva and oral health an essential overview for the health professional fourth edition. https://www.semanticscholar.org/paper/Saliva-and-oral-health-an-essential-overview-for-Edgar-Dawes/2dacd25944d8257b30f71ff4e1543323ade10c4a. Accessed 15 Apr 2022

  3. Mandel ID (1987) The functions of saliva. J Dent Res 66:623–627. https://doi.org/10.1177/00220345870660S203

    Article  PubMed  Google Scholar 

  4. Pedersen A, Sørensen CE, Proctor GB, Carpenter GH (2018) Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral Dis 24:1399–1416. https://doi.org/10.1111/odi.12867

    Article  PubMed  Google Scholar 

  5. Humphrey SP, Williamson RT (2001) A review of saliva: normal composition, flow, and function. J Prosthet Dent 85:162–169. https://doi.org/10.1067/mpr.2001.113778

    Article  CAS  PubMed  Google Scholar 

  6. Proctor GB, Carpenter GH (2007) Regulation of salivary gland function by autonomic nerves. Auton Neurosci 133:3–18. https://doi.org/10.1016/j.autneu.2006.10.006

    Article  CAS  PubMed  Google Scholar 

  7. Proctor GB, Carpenter GH (2014) Salivary secretion: mechanism and neural regulation. Monogr Oral Sci 24:14–29. https://doi.org/10.1159/000358781

    Article  PubMed  Google Scholar 

  8. Hutchings JB, Lillford PJ (1988) The perception of food texture - the philosophy of the breakdown path. J Texture Stud 19:103–115. https://doi.org/10.1111/j.1745-4603.1988.tb00928.x

    Article  Google Scholar 

  9. Amerongen AVN, Veerman ECI (2002) Saliva–the defender of the oral cavity. Oral Dis 8:12–22. https://doi.org/10.1034/j.1601-0825.2002.1o816.x

    Article  PubMed  Google Scholar 

  10. Lagerlöf F, Dawes C (1984) The volume of saliva in the mouth before and after swallowing. J Dent Res 63:618–621. https://doi.org/10.1177/00220345840630050201

    Article  PubMed  Google Scholar 

  11. Kapila YV, Dodds WJ, Helm JF, Hogan WJ (1984) Relationship between swallow rate and salivary flow. Digest Dis Sci 29:528–533. https://doi.org/10.1007/BF01296273

    Article  CAS  PubMed  Google Scholar 

  12. Nederkoorn C, Smulders FTY, Jansen A (1999) Recording of Swallowing events using electromyography as a non-invasive measurement of salivation. Appetite 33:361–369. https://doi.org/10.1006/appe.1999.0268

    Article  CAS  PubMed  Google Scholar 

  13. Rudney JD, Ji Z, Larson CJ (1995) The prediction of saliva swallowing frequency in humans from estimates of salivary flow rate and the volume of saliva swallowed. Arch Oral Biol 40:507–512. https://doi.org/10.1016/0003-9969(95)00004-9

    Article  CAS  PubMed  Google Scholar 

  14. Bulmer JM, Ewers C, Drinnan MJ, Ewan VC (2021) Evaluation of spontaneous swallow frequency in healthy people and those with, or at risk of developing, dysphagia: a review. Gerontol Geriatr Med 7:23337214211041800. https://doi.org/10.1177/23337214211041801

    Article  Google Scholar 

  15. Murray J, Langmore SE, Ginsberg S, Dostie A (1996) The significance of accumulated oropharyngeal secretions and swallowing frequency in predicting aspiration. Dysphagia 11:99–103. https://doi.org/10.1007/BF00417898

    Article  CAS  PubMed  Google Scholar 

  16. Palsy S (2021) 28th Annual meeting of the dysphagia research society. Dysphagia 36:1118–1184. https://doi.org/10.1007/s00455-020-10221-z

    Article  Google Scholar 

  17. WHO (1992) WHO expert coomittee on recent advances in oral health. Recent advances in oral health: report of a WHO expert committee. WHO technical report series. World Health Organization, Geneva, p 38

    Google Scholar 

  18. Abe K, Weisz SEM, Dunn RL, DiGioacchino MC, Nyentap JA, Stanbouly S, Theurer JA, Bureau Y, Affoo RH, Martin RE (2015) Occurrences of yawn and swallow are temporally related. Dysphagia 30:57–66

    Article  PubMed  Google Scholar 

  19. Navazesh M (1993) Methods for collecting saliva. Ann N Y Acad Sci 694:72–77. https://doi.org/10.1111/j.1749-6632.1993.tb18343.x

    Article  CAS  PubMed  Google Scholar 

  20. Shannon IL (1969) Specific gravity and osmolality of human parotid fluid. CRE 3:149–158. https://doi.org/10.1159/000259578

    Article  CAS  Google Scholar 

  21. Huckabee M-L, McIntosh T, Fuller L, Curry M, Thomas P, Walshe M, McCague E, Battel I, Nogueira D, Frank U, van den Engel-Hoek L, Sella-Weiss O (2018) The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and international normative data. Int J Lang Commun Disord 53:144–156. https://doi.org/10.1111/1460-6984.12332

    Article  PubMed  Google Scholar 

  22. Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191

    Article  PubMed  Google Scholar 

  23. Affoo RH, Trottier K, Garrick R, Mascarenhas T, Jang Y, Martin RE (2018) The effects of tooth brushing on whole salivary flow rate in older adults. Biomed Res Int 2018:3904139. https://doi.org/10.1155/2018/3904139

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Glass GV, Peckham PD, Sanders JR (1972) Consequences of failure to meet assumptions underlying the fixed effects analyses of variance and covariance. Rev Educ Res 42:237–288. https://doi.org/10.3102/00346543042003237

    Article  Google Scholar 

  25. Portney L, Watkins M (2000) Foundations of clinical research: applications to practice, 3rd edn. Prentice Hall, New Jersey

    Google Scholar 

  26. Ishijima T, Koshino H, Hirai T, Takasaki H (2004) The relationship between salivary secretion rate and masticatory efficiency. J Oral Rehabil 31:3–6. https://doi.org/10.1111/j.1365-2842.2004.01033.x

    Article  CAS  PubMed  Google Scholar 

  27. Milford EM, Wang B, Smith K, Choi D, Martin-Harris B, Garand KLF (2020) Aging and sex effects on mastication performance in healthy, nondysphagic, community-dwelling adults. Am J Speech Lang Pathol. https://doi.org/10.1044/2019_AJSLP-19-00097

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ikebe K, Matsuda K, Morii K, Furuya-Yoshinaka M, Nokubi T, Renner RP (2006) Association of masticatory performance with age, posterior occlusal contacts, occlusal force, and salivary flow in older adults. Int J Prosthodont 19:475–481

    PubMed  Google Scholar 

  29. Pereira LJ, Duarte Gaviao MB, Van Der Bilt A (2006) Influence of oral characteristics and food products on masticatory function. Acta Odontol Scand 64:193–201. https://doi.org/10.1080/00016350600703459

    Article  PubMed  Google Scholar 

  30. Dawes C (2005) The unstimulated salivary flow rate after prolonged gum chewing. Arch Oral Biol 50:561–563. https://doi.org/10.1016/j.archoralbio.2004.10.016

    Article  CAS  PubMed  Google Scholar 

  31. Shimada A, Baad-Hansen L, Svensson P (2015) Effect of experimental jaw muscle pain on dynamic bite force during mastication. Arch Oral Biol 60:256–266. https://doi.org/10.1016/j.archoralbio.2014.11.001

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

A version of this study has been published in an abstract form [16]. This work would not be possible without the generous support of the participants.

Funding

This work was completed with Central Michigan University Internal Research Support (RHA).

Author information

Authors and Affiliations

  1. School of Communication Sciences and Disorders, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St., Halifax, NS, B3M 1N8, Canada

    Rebecca H. Affoo

  2. Central Michigan University, College of Health Professions, 1280 East Campus Dr., Mt. Pleasant, MI, 48859, USA

    Rebecca H. Affoo

  3. SCL Health, Platte Valley Medical Center, 1606 Prairie Center Pkwy, Suite 130, Brighton, CO, 80601, USA

    Ciara Nellenbach

  4. University of Michigan Health System, MyMichigan Physicians Group, Central Michigan University, 4851 E. Pickard Street, Suite 2700, Mt. Pleasant, MI, 48858, USA

    Joe Chomchai

  5. Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-School of Medicine and Public Health, Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison GRECC (11G), Room D4240, Madison, WI, 53705, USA

    Nicole Rogus-Pulia

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  1. Rebecca H. Affoo
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Correspondence to Rebecca H. Affoo.

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Affoo, R.H., Nellenbach, C., Chomchai, J. et al. The effects of endoscope placement in the hypopharynx on swallowing-related measures in healthy adults. Eur Arch Otorhinolaryngol 280, 4979–4985 (2023). https://doi.org/10.1007/s00405-023-08114-6

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