title: Detecting Aspiration and Penetration Using FEES With and Without Food Dye.
abstract: The objective of this investigation was to determine if there were differences in identifying airway invasion (penetration or aspiration) during fiberoptic endoscopic evaluations of swallowing (FEES) for green-dyed versus non-dyed liquids. Forty adult inpatients in an acute care hospital underwent FEES, with both green-dyed liquids and naturally white liquids. Three speech-language pathologists rated aspiration and penetration for trials of nectar-thick milk and thin milk, both with and without green food dye. A subset of participants having excess pharyngeal/laryngeal secretions, as measured by the Secretions Severity Scale, were also analyzed for a difference in the detection of airway invasion and pharyngeal residue. No significant differences were found between dyes in airway invasion across all bolus types within participants. Significant differences were found in penetration ratings for large volumes of thin liquids (90 ml), between participants. When examining only discrepant airway invasion judgments for green-white swallow pairs, statistically significantly deeper airway invasion was measured for green-dyed boluses versus white for three of the five bolus types. Repeat rater reliability was better for dyed versus undyed liquids. Findings suggest that the use of green dye may allow for improved judgment of airway invasion.
authors.affiliation: Department of Surgery, Voice & Swallow Clinic, University of Wisconsin, Madison, G3/2 Clinical Science Center, 600 Highland Ave, Madison, WI, 53792, USA. marvin@surgery.wisc.edu.
authors.forename: Stevie
authors.initials: S
authors.lastname: Marvin
authors.affiliation: Department of Surgery, Voice & Swallow Clinic, University of Wisconsin, Madison, G3/2 Clinical Science Center, 600 Highland Ave, Madison, WI, 53792, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Gustafson
authors.affiliation: Department of Surgery, Voice & Swallow Clinic, University of Wisconsin, Madison, G3/2 Clinical Science Center, 600 Highland Ave, Madison, WI, 53792, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Thibeault
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D004396:Coloring Agents; D003679:Deglutition / Q000502:physiology; D004350:Drug Residues / Q000032:analysis; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods*; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008892:Milk; D015588:Observer Variation; D010614:Pharynx / Q000378:metabolism / Q000473:pathology; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000175:diagnosis*; D012720:Severity of Illness Index
chemical_list: D004396:Coloring Agents
keywords: Aspiration; Deglutition; Deglutition disorders; Dysphagia; Fiberoptic endoscopic evaluation of swallowing; Food dye; Green dye; Secretion severity scale