Esophageal Swallowing Timing Measures in Healthy Adults During Videofluoroscopy.
OBJECTIVE
Establishing the range of normal esophageal bolus transit times (ETT) is valuable when distinguishing pathology from normal variance, especially in elderly patients, and has not been documented for paste or pill. The aim of this study was to measure esophageal transit of liquid, paste, and pill during upright videofluoroscopy.


METHODS
One hundred eighteen healthy adults (mean age 54; range 20-98 years; SD = 21.40) with no complaints of dysphagia completed a videofluoroscopy with esophageal visualization including 20 ml liquid barium, 5 ml paste, and pill.


RESULTS
Mean ETTs were: 20 ml fluid, 10.7 seconds (SD = 13.6, median = 5.76, IQR = 4.33, range, 2.0-60.0); pill, 25.3 seconds (SD = 24.0, median = 12.70, IQR = 49.81, range, 1.0-60.0); paste, 28.6 seconds (SD = 23.31, median = 17.47, IQR = 53, range, 4.0-60.0). Age was significantly associated with increasing 20 ml fluid ETT (P < .001) but not pill (P = .58) or paste ETT (P = .12). Fluid ETT over 10 seconds occurred in 10% of participants between 20 and 59 years, in comparison to 35% over 60 years (P < .001).


CONCLUSIONS
These normative values provide a standardized protocol and guidance in interpretation when completing esophageal visualization as part of videofluoroscopy. While measuring fluid ETT may support referral for further specialist investigations, slower paste and pill ETT may be normal findings. Age-related slowing in fluid ETT was seen in healthy adults. Further investigation of ETT is needed in both normal and dysphagic subjects.
Speech Science, University of Auckland, New Zealand a.miles@auckland.ac.nz.
Anna
A
Miles
Speech Science, University of Auckland, New Zealand.
Stacie
S
Clark
Speech Science, University of Auckland, New Zealand.
Marie
M
Jardine
Speech Science, University of Auckland, New Zealand Department of Otorhinolaryngology, Northshore Hospital, Takapuna, Auckland, New Zealand.
Jacqui
J
Allen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media; D003679:Deglutition / Q000502:physiology*; D004947:Esophagus / Q000000981:diagnostic imaging*; D005471:Fluoroscopy; D064368:Healthy Volunteers; D006801:Humans; D008875:Middle Aged; D014741:Video Recording; D055815:Young Adult
D003287:Contrast Media; D001466:Barium Sulfate
deglutition; dysphagia; esophageal transit times; esophagus; pill transit; videofluoroscopy