Evaluation of Epiglottal Perception of Bolus Delivery during Stage II Transport

• Published in: The Japanese Journal of Dysphagia Rehabilitation Vol. 17; no. 3; pp. 217 - 225
• Main Authors: OZAKI, Kenichi, YAMADA, Kohei, TANAKA, Yoshinobu, KONDO, Izumi, SUGIYAMA, Shintaro, OZAWA, Shogo, YOSHIOKA, Fumi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Dysphagia Rehabilitation 31.12.2013; 一般社団法人 日本摂食嚥下リハビリテーション学会
• Subjects: enzyme homogeneous permeation; epiglottal perception; food texture; sensory evaluation method; Stage II transport; 喉頭蓋感覚; 官能評価法; 酵素均質浸透法; 食品テクスチャー
• ISSN: 1343-8441; 2434-2254
• DOI: 10.32136/jsdr.17.3_217

Objectives:　Some articles on dysphagia have reported that laryngopharyngeal sense influences the occurrence of aspiration pneumonitis. However, propelling of the bolus into the pharynx during Stage II transport is seldom perceived. The purposes of this study were to evaluate epiglottal perception of arrived bolus during Stage II transport using actual food and to determine the effect of differences in food texture on the epiglottal perception.Methods:　Twenty healthy volunteers chewed three food samples cooked to different grades of texture (hard, soft and medium), using enzyme homogeneous permeation. The subjects made a sign when they felt that the bolus had reached the epiglottis during Stage II transport. We evaluated the actual location of the bolus using videoendoscopy when the subject perceived that the food had arrived at their epiglottis.Results:　There were statistically significant differences between soft and hard food textures for both the duration from the beginning of chewing to the sign from the subjects and to arrival of the bolus at the epiglottis. The difference between the duration from the beginning of chewing to the sign from the subjects and to actual arrival of the bolus at the epiglottis did not depend on food texture and no significant difference was observed among the three food textures. Most subjects made a sign when the food arrived at about the posterior part of the tongue and the epiglottis.Discussion:　The healthy subjects could not correctly perceive the arrival of the bolus at the epiglottis during Stage II transport. Additionally, the texture of the test food did not affect epiglottal perception.Therefore, it is speculated that variations in mastication time might make the processed bolus a similar texture before the occurrence of swallowing.