title: Factors influencing bolus dwell times in healthy older adults assessed endoscopically.
abstract: OBJECTIVE
  Scant data exist on normal bolus dwell time assessed during flexible endoscopic evaluation of swallowing (FEES). The purpose of this study was to examine bolus dwell time in healthy older adults. Because it has been previously reported that some healthy older adults aspirate, we also sought to determine if bolus dwell time varied as a function of aspiration status.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Seventy-six healthy volunteers from the seventh, eighth, and ninth decades of life participated. Dwell times were analyzed via FEES as a function of pharyngeal location, liquid type, delivery method, purée type, viscosity, age, and gender.
  
  
  RESULTS
  Longer dwell times were evidenced with the eldest participants, straw delivery, and the smallest volume. Adults in the ninth decade were 4.8 (P = .01) and 3.8 (P = .02) times more likely to have longer dwell times at the vallecula and 7.1 (P = .002) and 3.8 (P = 0.02) at the pyriform sinus than those in the seventh and eighth decades, respectively. Longer dwell times at the vallecula and pyriform sinuses were 2 and 2.38 times (P < .0001) more likely for straw than cup delivery, respectively. Boluses of 5 mL were 1.5 times (P < .05) more likely to result in longer dwell times than larger volumes. Bolus dwell times did not significantly differ as a function of aspiration status.
  
  
  CONCLUSIONS
  Advanced age, straw delivery, and small volumes yielded longer dwell times. These variables should be considered before diagnosing an abnormal bolus dwell time in elder patients.
authors.affiliation: Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. sbutler@wfubmc.edu
authors.forename: Susan G
authors.initials: SG
authors.lastname: Butler
authors.forename: Jonathan
authors.initials: J
authors.lastname: Maslan
authors.forename: Andrew
authors.initials: A
authors.lastname: Stuart
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Leng
authors.forename: Erika
authors.initials: E
authors.lastname: Wilhelm
authors.forename: Catherine Rees
authors.initials: CR
authors.lastname: Lintzenich
authors.forename: Jeff
authors.initials: J
authors.lastname: Williamson
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis; D015154:Esophageal Motility Disorders / Q000175:diagnosis; D005260:Female; D005502:Food; D005772:Gastrointestinal Transit / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D013997:Time Factors; D014783:Viscosity
references.citation: Ann Otol Rhinol Laryngol. 2009 Feb;118(2):99-106
references.pmid: 19326759
references.citation: Ann Otol Rhinol Laryngol. 2009 Mar;118(3):190-8
references.pmid: 19374150
references.citation: Dysphagia. 1989;4(3):146-50
references.pmid: 2640187
references.citation: Dysphagia. 2005 Fall;20(4):290-6
references.pmid: 16633874
references.citation: J Speech Lang Hear Res. 2000 Dec;43(6):1481-92
references.pmid: 11193967
references.citation: Laryngoscope. 2010 Nov;120(11):2147-52
references.pmid: 20938951
references.citation: Dysphagia. 1992;7(4):187-200
references.pmid: 1308667
references.citation: Am J Physiol. 1989 Apr;256(4 Pt 2):R822-6
references.pmid: 2705572
references.citation: Am J Speech Lang Pathol. 2007 May;16(2):140-7
references.pmid: 17456892
references.citation: J Speech Lang Hear Res. 2004 Feb;47(1):33-45
references.pmid: 15072526
references.citation: Dysphagia. 1994 Spring;9(2):90-5
references.pmid: 8005013
references.citation: Physiol Rev. 1982 Jan;62(1):129-84
references.pmid: 7034008
references.citation: Dysphagia. 2001 Summer;16(3):176-82
references.pmid: 11453563
references.citation: Dysphagia. 2005 Fall;20(4):266-72
references.pmid: 16633870
references.citation: Folia Phoniatr Logop. 1998 Nov-Dec;50(6):311-9
references.pmid: 9925954
references.citation: Gastroenterology. 1997 Jan;112(1):73-83
references.pmid: 8978345