title: Physiological factors related to aspiration risk: a systematic review.
abstract: Penetration-aspiration is considered the most serious component of oropharyngeal dysphagia. Clinicians regularly evaluate the pathophysiology of swallowing and postulate reasons or mechanisms behind penetration-aspiration. In this article we share the results of a two-stage literature review designed to elucidate the association between abnormalities in physiological measures of swallowing function and the occurrence of penetration-aspiration. In the first stage, a broad scoping review was undertaken using search terms for nine different structures involved in oropharyngeal swallowing. In the second stage, based on the results of the initial search, a more focused systematic review was undertaken which explored the association between aspiration and abnormalities in respiratory, tongue, hyoid, and laryngeal function in swallowing. A total of 37 articles underwent detailed quality review and data extraction in the systematic review. The results support measurement of tongue strength, anatomically normalized measures of hyoid movement, bolus dwell time in the pharynx while the larynx remains open, respiratory rate, and respiratory swallow phasing as parameters relevant to aspiration risk.
authors.affiliation: Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, #12-101, Toronto, ON, M5G 2A2, Canada, catriona.steele@uhn.ca.
authors.forename: Catriona M
authors.initials: CM
authors.lastname: Steele
authors.forename: Julie A Y
authors.initials: JA
authors.lastname: Cichero
mesh_terms: D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006928:Hyoid Bone / Q000503:physiopathology; D007830:Larynx / Q000503:physiopathology; D012119:Respiration; D053120:Respiratory Aspiration / Q000209:etiology* / Q000503:physiopathology*; D012307:Risk Factors; D014059:Tongue / Q000503:physiopathology