[Dysphagia] Logemann results

[Wilma.Clancy at cdha.nshealth.ca (Wilma Clancy)]

I hope everyone reads this article.
 
Perlman PW; Cohen MA; Setzen M; Belafsky PC; Guss J; Mattucci KF;
Ditkoff M The risk of aspiration of pureed food as determined by
flexible endoscopic evaluation of swallowing with sensory testing.
Otolaryngol Head Neck Surg 2004 ;130:80-3   
 
I read it for the first time this morning.  
 
The researchers divided the subjects into 6 groups:  normal sensation,
normal motor funtion; normal sensation, absent motor function; moderate
decreased sensation, normal motor function; moderate decreased
sensation, absent motor function: severe/absent sensation, normal motor
function; and severe/absent sensation, absent motor function. 
 
Only a teaspoon of puree consistency bolus was used in this trial. 
There is no comparison with thick or thin liquids.
 
In the discussion they write:  "We demonstrated that there is a minimal
risk of aspiration of pureed foods with an intact squeeze with no
significant difference as sensation worsens.  When there exists an
impaired squeeze, aspiration was present at all levels of sensation but
did not significantly vary as sensation worsened.  In our study, as in
those of Aviv et al, we demonstrated that patients with impaired squeeze
and normal sensation can aspirate pureed foods.  It appears from these
studies that the motor component of the swallow is more important than
sensation when administrating a pureed diet and the sensory component is
more important for the safe consumption of thin liquids.  The clinical
implication of these findings is that persons with an intact squeeze
should be able to consume pureed food."
 
I hope this helps to clarify Perlman et al's work.
Sincerely,
Wilma Clancy
Neurology Dietitian