[Dysphagia] silent aspiration

[wabeach at hsc.vcu.edu (wabeach@hsc.vcu.edu)]

Part of the answer to your question (and I too look forward to Irene's
response) is that we have not data telling us how often aspiration of
any sort leads to pneumonia. We know that aspiration pneumonia is
caused by bacteria beign transported into the lungs and overcoming
resistance in the host. We know that aspiration is not one of the
prime factors which causes aspiration pneumonia (see Langmore, 1998,
in Dysphagia regarding her factor analysis of causes of aspiration
pneumonia). We also know that bacteria can make its way into the lungs
by way of salivary aspiration outside of meals. I am unaware of any
research telling us the frequency that this mechanism causes
pneumonia. Unfortunately, 25 years ago when dysphagiology was being
invented these studies were not done, leading us to the problems that
we face today. Aspiration in and of itself is not the problem, it is
what happens afterwards. You might try to obtain the ASHA dysphagia
interest group newsletter of March 2005 which reviews some of these
factors more.


Woodford A. Beach, Ph.D., CCC/SP
Senior Speech Pathologist
Adjunct Assistant Professor of Neurology and PM&R
VCU Medical Center
Richmond, VA

------------------
>   I have a question regarding thickened liquids that I would like
anyone with Dr. Irene-Campbell-Taylor's viewpoint to try to clear up
for me (not that I don't want to here from everyone else!).  I often
hear Dr. Campbell-Taylor talk about how we need to find the cause of
the dysphagia and treat that, not to just treat the dysphagia (which I
totally agree with) and that thickened liquids have no scientific
proof behind them (which I also understand).  My question would be,
(Dr. Campbell-Taylor I would love if you read this and responded!),
does this mean you believe that thickened liquids are never indicated?
 My second question would be r/t silent aspiration:  How could silent
aspiration be diagnosed without doing a MBS? (please someone don't say
"if they have/get pneumonia").  Thank you anyone for your input.
>    
>   New SLP
> 
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> 
Woodford A. Beach, Ph.D., CCC/SP
Senior Speech Language Pathologist, VCUMC
Adjunct Asst. Professor, Neurology
Adjunct Asst. Professor, PM&R
Asst. Clinical Professor, Otolaryngology/Head & Neck Surgery
Virginia Commonwealth University
Richmond, VA 23298