title: Application of simple swallowing provocation test with fiberoptic endoscopic evaluation of swallowing in a cross-sectional study.
abstract: BACKGROUND
  This study aimed to develop a simultaneously swallowing provocation test for dysphagia patients undergoing fiberoptic endoscopic evaluation of swallowing (FEES), as well as to evaluate its efficacy.
  
  
  METHODS
  In this test, 0·4 and 2·0 mL volumes of water were dripped into the pharynx under endoscopic examination of swallowing, and determine the latency time (LT) of the swallowing reflex elicited by water. The subjects were 51 bed-bound patients with dysphagia and could be divided into two groups as 35 tube feeding and 16 oral intake subjects. Among the tube feeding subjects, 20 patients who started dysphagia rehabilitation were followed-up to 3 months.
  
  
  RESULTS
  The mean LT was 7·43 ± 7·19 seconds with 0·4 mL of test water and 5·05 ± 5·59 sec with 2·0 mL. When 0·4 mL water was dripped, LT was significantly longer in tube feeding (10·49 ± 7·97 seconds) than oral intake subgroup (5·72 ± 5·16 seconds) (p < 0·05). After the dietary intervention according to the result of FEES, 5 patients were improved in eating, and 15 patients were unchanged or even got worse among 3-months follow-up investigation. LT with 0.4 ml of test water of the Improved group was 3·16 ± 2·69 seconds and that of unchanged/worsened group was 22·6 ± 17·5 seconds, resulting in the significant difference (p < 0·05).
  
  
  CONCLUSIONS
  The results of this study suggest that our endoscopic swallowing test as swallowing provocation test with FEES is a useful examination for dysphagia rehabilitation.
authors.affiliation: Division of Clinical Oral Rehabilitation, the Nippon Dental University, Graduate School of Life Dentistry, Tokyo, Japan. chiharu-tejima@umin.ac.jp.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Tejima
authors.affiliation: Division of Clinical Oral Rehabilitation, the Nippon Dental University, Graduate School of Life Dentistry, Tokyo, Japan. kikutani@tokyo.ndu.ac.jp.|Division of Rehabilitation for Speech and Swallowing Disorders, the Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan. kikutani@tokyo.ndu.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kikutani
authors.affiliation: Division of Rehabilitation for Speech and Swallowing Disorders, the Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan. high-bri@tokyo.ndu.ac.jp.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Division of Rehabilitation for Speech and Swallowing Disorders, the Nippon Dental University, Tama Oral Rehabilitation Clinic, Tokyo, Japan. fumita@tokyo.ndu.ac.jp.
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Tamura
authors.affiliation: Dental Department, Hiroshima City Rehabilitation Hospital, Hiroshima, Japan. mitsu@hiroshima-u.ac.jp.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Yoshida
mesh_terms: D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D012720:Severity of Illness Index