Can the Repetitive Saliva Swallow Test Predict Airway Invasion in All Cause Dysphagia?

IF 2.2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Laryngoscope Pub Date : 2025-03-25 DOI:10.1002/lary.32137

David Kiderman, Boaz Gantz, Shir Boaron-Sharafi, Yonatan Lahav, Raviv Allon, Yael Shapira-Galitz

{"title":"Can the Repetitive Saliva Swallow Test Predict Airway Invasion in All Cause Dysphagia?","authors":"David Kiderman, Boaz Gantz, Shir Boaron-Sharafi, Yonatan Lahav, Raviv Allon, Yael Shapira-Galitz","doi":"10.1002/lary.32137","DOIUrl":null,"url":null,"abstract":"Objectives: The repetitive saliva swallow test (RSST) is a simple, noninvasive screening tool for oropharyngeal dysphagia, validated to detect aspiration in individuals with neurogenic dysphagia. This study aims to evaluate the diagnostic properties of the RSST in predicting airway invasion in an all-cause dysphagia population using fiberoptic endoscopic evaluation of swallowing (FEES) as the gold standard.Methods: A retrospective review including 87 adult outpatients from a dysphagia clinic was conducted. Each patient underwent both RSST and FEES. The primary outcome measure was the RSST's diagnostic performance against FEES-determined airway invasion (penetration-aspiration scale, PAS ≥ 3).Results: The study cohort had a median RSST score of 5, and 32% demonstrated airway invasion on FEES. Higher RSST scores were associated with a lower likelihood of airway invasion (OR: 0.79, p = 0.03). On receiver operating characteristic curve analysis, RSST had an area under the curve of 0.64, with an optimal cutoff of ≤ 6 swallows, yielding 89% sensitivity and 34% specificity.Conclusion: The RSST demonstrates statistical compatibility for airway invasion screening in an all-cause dysphagia population. However, its high cutoff values hinder its clinical utility due to modest specificity.Level of evidence: Class III.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32137","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: The repetitive saliva swallow test (RSST) is a simple, noninvasive screening tool for oropharyngeal dysphagia, validated to detect aspiration in individuals with neurogenic dysphagia. This study aims to evaluate the diagnostic properties of the RSST in predicting airway invasion in an all-cause dysphagia population using fiberoptic endoscopic evaluation of swallowing (FEES) as the gold standard.

Methods: A retrospective review including 87 adult outpatients from a dysphagia clinic was conducted. Each patient underwent both RSST and FEES. The primary outcome measure was the RSST's diagnostic performance against FEES-determined airway invasion (penetration-aspiration scale, PAS ≥ 3).

Results: The study cohort had a median RSST score of 5, and 32% demonstrated airway invasion on FEES. Higher RSST scores were associated with a lower likelihood of airway invasion (OR: 0.79, p = 0.03). On receiver operating characteristic curve analysis, RSST had an area under the curve of 0.64, with an optimal cutoff of ≤ 6 swallows, yielding 89% sensitivity and 34% specificity.

Conclusion: The RSST demonstrates statistical compatibility for airway invasion screening in an all-cause dysphagia population. However, its high cutoff values hinder its clinical utility due to modest specificity.

Level of evidence: Class III.

查看原文本刊更多论文

重复唾液吞咽试验能否预测全因性吞咽困难的气道侵犯？

目的：重复性唾液吞咽试验（RSST）是一种简单、无创的口咽吞咽困难筛查工具，经验证可用于检测神经源性吞咽困难患者的误吸。本研究旨在评估RSST在全因吞咽困难人群中预测气道侵犯的诊断特性，以光纤内镜吞咽评估（FEES）为金标准。方法：对87例成人吞咽困难门诊患者进行回顾性分析。每位患者均接受了RSST和FEES检查。主要结局指标是RSST对由fees确定的气道侵犯的诊断性能（穿透-吸入量表，PAS≥3）。结果：研究队列的RSST中位评分为5分，32%的患者表现出气道侵犯。RSST评分越高，气道侵犯的可能性越低（OR: 0.79, p = 0.03）。在受试者工作特征曲线分析中，RSST曲线下面积为0.64，最佳截止≤6只燕子，敏感性89%，特异性34%。结论：RSST在全因吞咽困难人群的气道侵犯筛查中具有统计学上的兼容性。然而，由于特异性不高，它的高截止值阻碍了它的临床应用。证据等级：III类。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects