Taste Manipulation and Swallowing Mechanics in Trauma-Related Sensory-Based Dysphagia

Angela M Dietsch, H. Duncan Dorris, William G. Pearson, Katie E. Dietrich-Burns, Nancy Pearl Solomon

Research output: Contribution to journalArticle

Abstract

Purpose This study explored the effects of high-concentration taste manipulation trials on swallow function in persons with sensory-based dysphagia. Method Dysphagia researchers partnered with clinical providers to prospectively identify traumatically injured U.S. military service members (N = 18) with sensory-based dysphagia as evidenced by delayed initiation and/or decreased awareness of residue/penetration/aspiration. Under videofluoroscopy, participants swallowed trials of 3 custom-mixed taste stimuli: unflavored (40% weight/volume [wt/vol] barium sulfate in distilled water), sour (2.7% wt/vol citric acid in 40% wt/vol barium suspension), and sweet-sour (1.11% wt/vol citric acid plus 8% wt/vol sucrose in 40% wt/vol barium suspension). Trials were analyzed and compared via clinical rating tools (the Modified Barium Swallow Impairment Profile [Martin-Harris et al., 2008] and the Penetration-Aspiration Scale [Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996]). Additionally, a computational analysis of swallowing mechanics (CASM) was applied to a subset of 9 swallows representing all 3 tastants from 3 participants. Results Friedman's tests for the 3 stimuli revealed significantly (p < .05) improved functional ratings for Penetration-Aspiration Scale and pharyngoesophageal opening. CASM indicated differences in pharyngeal swallowing mechanics across all tastant comparisons (p ≤ .0001). Eigenvectors revealed increased tongue base retraction, hyoid elevation, and pharyngeal shortening for sweet-sour and, to a lesser extent, sour than for unflavored boluses. Conclusion Advantageous changes in certain parameters of oropharyngeal swallowing physiology were noted with high-intensity tastants per both clinical ratings and subsequent CASM, suggesting potential therapeutic application for taste manipulation.

Original languageEnglish (US)
Pages (from-to)2703-2712
Number of pages10
JournalJournal of speech, language, and hearing research : JSLHR
Volume62
Issue number8
DOIs
StatePublished - Aug 15 2019

Fingerprint

Deglutition
Deglutition Disorders
Mechanics
mechanic
manipulation
trauma
Weights and Measures
rating
Wounds and Injuries
Barium
Swallows
stimulus
Citric Acid
military service
Suspensions
physiology
Barium Sulfate
Tongue
water
Sucrose

ASJC Scopus subject areas

  • Language and Linguistics
  • Linguistics and Language
  • Speech and Hearing

Cite this

Taste Manipulation and Swallowing Mechanics in Trauma-Related Sensory-Based Dysphagia. / Dietsch, Angela M; Dorris, H. Duncan; Pearson, William G.; Dietrich-Burns, Katie E.; Solomon, Nancy Pearl.

In: Journal of speech, language, and hearing research : JSLHR, Vol. 62, No. 8, 15.08.2019, p. 2703-2712.

Research output: Contribution to journalArticle

Dietsch, Angela M ; Dorris, H. Duncan ; Pearson, William G. ; Dietrich-Burns, Katie E. ; Solomon, Nancy Pearl. / Taste Manipulation and Swallowing Mechanics in Trauma-Related Sensory-Based Dysphagia. In: Journal of speech, language, and hearing research : JSLHR. 2019 ; Vol. 62, No. 8. pp. 2703-2712.
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abstract = "Purpose This study explored the effects of high-concentration taste manipulation trials on swallow function in persons with sensory-based dysphagia. Method Dysphagia researchers partnered with clinical providers to prospectively identify traumatically injured U.S. military service members (N = 18) with sensory-based dysphagia as evidenced by delayed initiation and/or decreased awareness of residue/penetration/aspiration. Under videofluoroscopy, participants swallowed trials of 3 custom-mixed taste stimuli: unflavored (40{\%} weight/volume [wt/vol] barium sulfate in distilled water), sour (2.7{\%} wt/vol citric acid in 40{\%} wt/vol barium suspension), and sweet-sour (1.11{\%} wt/vol citric acid plus 8{\%} wt/vol sucrose in 40{\%} wt/vol barium suspension). Trials were analyzed and compared via clinical rating tools (the Modified Barium Swallow Impairment Profile [Martin-Harris et al., 2008] and the Penetration-Aspiration Scale [Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996]). Additionally, a computational analysis of swallowing mechanics (CASM) was applied to a subset of 9 swallows representing all 3 tastants from 3 participants. Results Friedman's tests for the 3 stimuli revealed significantly (p < .05) improved functional ratings for Penetration-Aspiration Scale and pharyngoesophageal opening. CASM indicated differences in pharyngeal swallowing mechanics across all tastant comparisons (p ≤ .0001). Eigenvectors revealed increased tongue base retraction, hyoid elevation, and pharyngeal shortening for sweet-sour and, to a lesser extent, sour than for unflavored boluses. Conclusion Advantageous changes in certain parameters of oropharyngeal swallowing physiology were noted with high-intensity tastants per both clinical ratings and subsequent CASM, suggesting potential therapeutic application for taste manipulation.",
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