title: Classification of sequential swallowing types using videoendoscopy with high reproducibility and reliability.
abstract: OBJECTIVE
  This study aimed to classify sequential swallowing types using videoendoscopy (VE) avoiding radiation exposure and compare the results using videofluoroscopy (VF).
  
  
  METHODS
  Twenty-one healthy adults simultaneously underwent VF and VE during sequential straw drinking. Each discrete swallow was classified into an L-segmental type (laryngeal vestibule opens after swallow) or L-continuous type (laryngeal vestibule closure continues after swallow) using VF and a V-segmental type (velopharynx opens after swallow) or V-continuous type (velopharynx closure continues after swallow) using VE. Test-retest reproducibility and interrater and intrarater reliability were evaluated in ten healthy adults.
  
  
  RESULTS
  Of 128 swallows, 94 were L-segmental and 34 were L-continuous types as per VF, whereas 95 were V-segmental and 33 were V-continuous types as per VE. The leading edge of the bolus at swallow onset was significantly deeper in L-continuous types (P = 0.001). Laryngeal vestibule closure on VF images corresponded to velopharyngeal closure on VE images for 127 of 128 swallows (κ = 0.98, P < 0.001). All subjects showed the same types of swallows in the first and the second studies. Both interrater and intrarater reliability were high.
  
  
  CONCLUSIONS
  VE showed high reproducibility and reliability in the classification of sequential swallowing types.
authors.affiliation: From the Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo (CS, HU, SM); Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi (HK, ES); Department of Rehabilitation, Ashikaga Red Cross Hospital, Ashikaga, Tochigi (MB, KO); Department of Dentistry, School of Medicine, Fujita Health University, Toyoake, Aichi (DK); and Department of Special Care Dentistry, Nagasaki University Hospital of Medicine and Dentistry, Nagasaki, Nagasaki, Japan (SM).
authors.forename: Chiaki
authors.initials: C
authors.lastname: Susa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kagaya
authors.forename: Eiichi
authors.initials: E
authors.lastname: Saitoh
authors.forename: Mikoto
authors.initials: M
authors.lastname: Baba
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kanamori
authors.forename: Shinya
authors.initials: S
authors.lastname: Mikushi
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Ozaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uematsu
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Minakuchi
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D003679:Deglutition / Q000502:physiology*; D004326:Drinking / Q000502:physiology*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008297:Male; D012016:Reference Values; D015203:Reproducibility of Results; D014743:Videotape Recording / Q000379:methods