Dysphagia最新文献

{"title":"Risk Factors Associated to Aspiration Pneumonia in Adults and Elderly Patients: A Scoping Review.","authors":"Claudia Santini Rossi, Rayane Délcia da Silva, Marcos Ribeiro, Angela Graciela Deliga Schroder, José Stechman-Neto, Bianca Simone Zeigelboim, Ahmad Al-Laham, Karinna Veríssimo Meira Taveira, Cristiano Miranda de Araújo, Rosane Sampaio Santos","doi":"10.1007/s00455-025-10887-3","DOIUrl":"10.1007/s00455-025-10887-3","url":null,"abstract":"<p><p>Aspiration Pneumonia has a significant impact on individuals of all age groups, which can result in morbidity and a substantial reduction in the quality of life. The objective of this study was to map, through a scoping review, the risk factors associated to aspiration pneumonia in adult and elderly patients. Mapping and analyzing these factors are essential to understand and manage aspiration pneumonia, contributing significantly to the advancement of knowledge about this clinical condition. This scoping review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) checklist. EMBASE, LILACS, PubMed/Medline, Scopus, Web of Science, and gray literature databases were systematically searched. The acronym 'PCCS' was used to consider the eligibility of studies for this review, where: P = Population (≥ 18 years of age), C = Concept (risk factors), C = Context (aspiration pneumonia), S = Studies (observational, interventional, cross-sectional studies, randomized, non-randomized and pseudo-randomized clinical studies). There were no restrictions regarding gender, ethnicity of individuals, language of the studies and date of publication. A comprehensive literature search was conducted using six electronic databases: EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS), Livivo, PubMed/Medline, Scopus, and Web of Science. In addition, gray literature was also explored through AshaWire, Google Scholar, Open Gray, and ProQuest. There were no restrictions regarding gender, ethnicity, language, time of publication, or diagnosis. A total of 3,183 articles were identified, including results from the gray literature. After screening, 56 articles were included. Significant risk factors related to aspiration pneumonia were identified. The risks include aspects such as dysphagia, aspiration, nutrition, neurological conditions, malnutrition, dehydration, changes in body mass index, skeletal mass index, mobility, and dependence on activities. Furthermore, hospital institutionalization, including length of stay, endotracheal intubation, and mechanical ventilation, is also associated.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"379-403"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acoustic Parameters of Swallowing in Adults and Older Adults: A Cross-Sectional Study.","authors":"Danielli Pires Vieira, Virgílio da Rocha Olsen, Dieine Estela Bernieri Schiavon, Mariana Costa Araújo, Rafaela Soares Rech","doi":"10.1007/s00455-025-10881-9","DOIUrl":"10.1007/s00455-025-10881-9","url":null,"abstract":"<p><p>Acoustic analysis is a promising resource for qualifying the clinical evaluation of swallowing and making it more objective. To compare the acoustic parameters of swallowing obtained from the capture of sounds by digital cervical auscultation in adults and older people. This is a cross-sectional study. Six groups were defined based on age range and the presence or absence of oropharyngeal dysphagia (OD): adults (18-59 years) with and without OD (G1 and G2), older individuals aged 60 to 75 years with and without OD (G3 and G4), and older individuals aged 76 years or older with and without OD (G5 and G6). A stethoscope with an amplifier was used to capture swallowing sounds, which were recorded during ingestion. Data analysis was conducted in R, and acoustic analysis was performed in Python. The study sample consisted of 408 participants, totaling 2057 swallows. In the G1 and G2, the magnitude and recurrence parameters differentiated between individuals with and without OD (p < 0.001). Among G3 and G4, the differences involved duration (p = 0.022), magnitude, phase, and recurrence (p < 0.001). Among G5 and G6, significant differences were found in the parameters phase (p = 0.012) and recurrence (p < 0.001). Significant differences in the acoustic parameters of swallowing were observed between groups, demonstrating the impact of age on normal swallowing and dysphagia. Recognizing age-related particularities and defining specific acoustic parameters of swallowing is crucial for enhancing clinical speech therapy practice through more precise and effective interventions.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"316-328"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Oral Health and Dysphagia in the Chinese Community-Dwelling Older Adults: A Cross-Sectional Study.","authors":"Qingwen Huang, Lancai Zhao, Yanxin Chen, Xiaona He, Yinglu Lin, Baoxian Wang, Chenxi Ye, Yufeng Qiu, Huafang Zhang","doi":"10.1007/s00455-025-10882-8","DOIUrl":"10.1007/s00455-025-10882-8","url":null,"abstract":"<p><p>Poor oral health and dysphagia are common age-related conditions, yet their interrelationship in Chinese community-dwelling older adults remains underexplored. To investigate the association between oral health and dysphagia in Chinese community-dwelling older adults using a dual-method screening. Cross-sectional study. Community health centers across Zhejiang Province, China. 3325 adults aged ≥ 65 years. Oral health was assessed via the Oral Health Assessment Tool (OHAT), and dysphagia was screened for using the Water Swallowing Test (WST) and the Eating Assessment Tool-10 (EAT-10). Multivariate logistic regression adjusted for confounders. Poor oral health prevalence was 78.9% (n = 2,622), and dysphagia prevalence was 17.7% (n = 587). Higher OHAT scores (OR = 1.094, 95% CI:1.023-1.170), dry lips (OR = 1.432), reduced saliva (OR = 1.454), fewer natural teeth (OR = 1.160), and dental pain (OR = 1.303) were significantly associated with dysphagia. We demonstrate that compromised oral health is an independent determinant of dysphagia in the Chinese geriatric population. These results compel the integration of mandatory oral health screenings within geriatric care protocols and the establishment of dentist-speech therapist-nutritionist teams as a critical standard for optimizing dysphagia outcomes.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"329-339"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mechanistic Investigation of Cerebellar Intermittent Theta-Burst Stimulation-Induced Changes in Pharyngeal Motor Cortex Excitability: A fNIRS-Based Study.","authors":"Zicai Liu, Huiyu Liu, Xin Wen","doi":"10.1007/s00455-025-10895-3","DOIUrl":"10.1007/s00455-025-10895-3","url":null,"abstract":"<p><p>Previous studies have shown that intermittent theta burst stimulation (iTBS) can promote the recovery of swallowing function in stroke patients. However, the therapeutic mechanism is not well understood. No study has elucidated the swallowing mechanism of iTBS and its cortical excitability changes in controlled healthy samples. Changes in cortical excitability can reflect the improvement of swallowing function. The purpose of this study was to observe the activation of the cerebral cortex during voluntary swallowing in healthy adults and to investigate the direct effect of cerebellar iTBS on the excitability of the pharyngeal motor cortex, to explore further the potential mechanisms by which cerebellar iTBS improves swallowing function. Thirty healthy subjects were recruited for this study and randomized to left and right cerebellar iTBS stimulation. The order of stimulation of the left and right cerebellum was randomized, and the stimulation interval was approximately one week. Functional near-infrared spectroscopy (fNIRS) was used to assess brain activation before and after iTBS stimulation and the parameter \"β-value.\" fNIRS was paradigmatized as a classical block task, and the whole procedure consisted of three identical blocks, each consisting of a 30-s swallowing task and a 30-s rest period. Bilateral superior temporal gyrus (STG), middle temporal gyrus (MTG), primary motor cortex (PMC), pre-motor and supplementary motor cortex (PSMC), primary somatosensory cortex (PSC), pars triangularis (PTG), frontopolar area (FPA), frontal eye fields (FEF), and dorsolateral prefrontal area (DLPFC)were significantly activated during the performance of a voluntary swallowing task. Compared with pre-stimulation, the beta values significantly increased in channels 5 (P = 0.013), 17 (P = 0.025), 18 (P = 0.027), 19 (P = 0.046), 34 (P = 0.045), and 37(P = 0.045) after left cerebellar stimulation; After cerebellar right side stimulation, the beta values significantly increased in channels 3 (P = 0.043), 18 (P = 0.022), 20 (P = 0.047), 38 (P = 0.032), 46 (P = 0.028), and 48 (P = 0.028). Bilateral STG, MTG, PMC, PSMC, PSC, PTG, FPA, FEF, and DLPFC were involved in regulating volitional swallowing. Both iTBS to the left and right cerebellum significantly increased the excitability of swallowing cortical areas under a swallowing-specific task.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"454-465"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Biofeedback on the Rehabilitation of People with Post-stroke Dysphagia: A Systematic Review and Meta-Analysis.","authors":"Lilian Toledo-Rodríguez, Michelle Casanova-Román, Hachi Manzur, Patricio Soto-Fernández","doi":"10.1007/s00455-025-10900-9","DOIUrl":"10.1007/s00455-025-10900-9","url":null,"abstract":"<p><p>To evaluate the effect of adding biofeedback to standard therapy in the rehabilitation of post-stroke dysphagia through a systematic review and meta-analysis. A comprehensive literature search was conducted in MEDLINE and EMBASE using the PICO framework and adhering to PRISMA guidelines. Four independent reviewers screened and selected studies for inclusion. Only randomized controlled trials were included in the meta-analysis. Risk of bias was evaluated using the Cochrane ROB-2 tool, and the certainty of evidence was rated according to the GRADE approach. Of the 118 studies initially retrieved, five met the criteria for inclusion in the quantitative analysis. All selected trials used surface electromyography (sEMG) biofeedback alongside conventional therapy. The primary outcomes evaluated were incidence of pneumonia, nasogastric tube removal, quality of life, and dysphagia severity. While the addition of biofeedback appeared to be associated with a higher rate of tube removal and some improvement in quality of life, no statistically significant difference was found in terms of clinical severity. Most outcomes were graded as having very low certainty due to imprecision and limited sample sizes. Biofeedback may offer added value to standard post-stroke dysphagia therapy, particularly in enhancing certain clinical outcomes such as transition to oral feeding and perceived quality of life. While initial findings are promising, more robust evidence is needed to fully establish the clinical role of biofeedback in this context.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"493-500"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swallowing and QoL Outcomes, Patient Experience and Treatment Related Priorities in Recurrent Oropharyngeal Cancer (rOPC)- a Mixed Method Study.","authors":"Grainne Brady, Justin Roe, Vinidh Paleri, Pernilla Lagergren, Mary Wells","doi":"10.1007/s00455-025-10898-0","DOIUrl":"10.1007/s00455-025-10898-0","url":null,"abstract":"<p><strong>Background: </strong>Recurrent oropharyngeal cancer (rOPC) presents challenging treatment decision-making. Toxicity from previous treatment, coupled with potential functional and quality of life (QoL) morbidity of further treatment(s) can influence decision-making regarding curative and non-curative treatment.</p><p><strong>Aim: </strong>To investigate swallowing and QoL outcomes, treatment-related priorities, and patient experience before and after rOPC treatment.</p><p><strong>Method: </strong>Longitudinal, multicentre, mixed method study. Outcomes included the MD Anderson Dysphagia Inventory (MDADI), Performance Status Scale for Head and Neck Cancer (PSS-HN), the University of Washington QoL Questionnaire (UWQoLv4), the Chicago Priority Scale (CPS) and semi-structured interviews.</p><p><strong>Results: </strong>The sample included 37 participants (prospective n = 25, retrospective n = 12, females n = 6) with a median age of 63 (range 41-88). The majority (n = 21) had curative intent treatment (surgery n = 20 or radiation n = 1). The remainder had non-curative intent immunotherapy (n = 14) or chemotherapy (n = 2). Swallowing and QoL were impaired at baseline; median MDADI composite score: 60 (IQR: 52.15-81.75), median PSS- HN normalcy of diet: (NoD): 50 and UWQoLv4 global health score (GHS): 60 (IQR 40-60). The PSS-HN NoD score deteriorated to 40 at six months. The MDADI and UWQoL data remained impaired. Triangulation with qualitative data revealed agreement with the PSS data and provided context for the relatively stable QoL. Being cured of cancer and living as long as possible remained the key priorities at all timepoints.</p><p><strong>Conclusion: </strong>In this study swallowing deteriorated with treatment for rOPC. Treatment-related priorities remained focused on cure or survival. If the treatment-related goal was achieved, patients adapted and experienced at least stable QoL regardless of swallowing status.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"473-482"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the Evidence-base for Clinician-Graded Dysphagia Using Dynamic Imaging Grade of Swallowing Toxicity (DIGEST): Validation Across Non-head and Neck Cancer Oncology Populations.","authors":"Beatrice Manduchi, Carla L Warneke, Xiaohui Tang, Sheila Buoy, Carly E A Barbon, Katherine A Hutcheson","doi":"10.1007/s00455-025-10875-7","DOIUrl":"10.1007/s00455-025-10875-7","url":null,"abstract":"<p><p>The Dynamic Imaging Grade of Swallowing Toxicity version 2 (DIGEST_v2) is a clinician-graded scale for assessing pharyngeal dysphagia in modified barium swallow (MBS) studies, initially validated for head and neck cancer (HNC) patients. Given the investigators' published clinical application more broadly in all oncology populations in a comprehensive cancer center, this study evaluated the validity of DIGEST_v2 across diverse non-HNC oncology populations. A retrospective analysis included 386 patients who underwent MBS studies at MD Anderson Cancer Center (2016-2021). Participants were randomly selected to represent a mix of the most common referrals for MBS (neuro-oncology, endocrine/thyroid, thoracic cancers, mixed cancer etiologies in both inpatient and outpatient care). Two independent raters, clinical and research, assigned DIGEST overall, safety, and efficiency grades. Inter-rater reliability was assessed using weighted kappa (κ_w). Criterion validity was evaluated against the MBSImP pharyngeal total score, and convergent construct validity against the MDADI physical score and the PSS-HN diet score, using Spearman's correlation coefficients (r_s) and Kruskal-Wallis tests. Analyses were stratified by disease and setting subgroups. Inter-rater reliability for the overall sample and subgroups was substantial for DIGEST overall, safety, and efficiency grades (κ_w = 0.68-0.71), with moderate agreement for efficiency in the endocrine/thyroid subgroup (κ_w = 0.55). DIGEST effectively differentiated levels of pharyngeal pathophysiology for the overall sample and subgroups (MBSImP: r_s=0.68-0.86, p < 0.05), demonstrating criterion validity. Associations with MDADI physical (r_s=-0.12 to -0.47) and PSS-HN diet (r_s=-0.23 to -0.49) indicated weak to moderate convergent construct validity. DIGEST demonstrated robust psychometric properties for assessing the severity of pharyngeal dysphagia across diverse non-HNC cancer populations, maintaining stable performance in common subgroups referred for MBS studies. This validation supports the broader use of DIGEST in oncology practice, addressing the need for reliable dysphagia assessment tools in oncology. KEY POINTS: - DIGESTv2 demonstrated substantial inter-rater reliability (κw = 0.68-0.71) between clinicians in real-world practice and research laboratory image grading across neuro-oncology, endocrine/thyroid, and thoracic cancer populations using routine clinical imaging data. - Criterion validity was confirmed by strong correlations with reference measures of swallowing function (rs = 0.68-0.86), validating DIGEST's ability to differentiate dysphagia severity. - DIGESTv2 performed consistently across subgroups commonly referred for videofluoroscopic-based swallowing evaluations, supporting its use as a standardized assessment method in oncology care.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"307-315"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study to Investigate the Effects of Bupivacaine Nasal Treatment in Palliative Care Patients with Swallowing Difficulty.","authors":"Athma Prasanna, Chinmayee Anand, B S Sunitha, Praveen Prasannan, Priya Arjun, Shubhangi Upadhyay, Namrata Bankoti, Nagasuma Chandra","doi":"10.1007/s00455-025-10890-8","DOIUrl":"10.1007/s00455-025-10890-8","url":null,"abstract":"<p><p>Dysphagia among end-of-life patients in palliative care is debilitating and requires symptomatic management. Current methods involving usage of IV fluids, total parenteral nutrition, intermittent oral liquid feeds, use of naso-gastric tubes or administration of nasal saline drops are inadequate in providing relief to the patient, warranting exploration of newer methods. At SSCHRC, a novel intervention of intranasal administration of Bupivacaine, a widely used anesthetic has been used successfully to treat end-of-life cancer patients, providing temporary relief for about half an hour with each administration, facilitating food and water intake. This study is aimed as a pilot to assess the feasibility of the study design in gathering molecular data on the effect of the treatment, especially on the mucin related pathways. Using throat swabs of patients, we obtained bulk RNAseq transcriptomes before and after the treatment. We analyze patterns of differential expression and use a genome-wide protein-protein interaction network approach to infer the affected pathways and processes. Our results indicate that the Bupivacaine treatment shows variation in gene expression in key genes and pathways that could potentially explain reduction in mucin secretion leading to relieving symptoms of dysphagia. It provides support for conducting a larger clinical study in order to study the effect in a larger cohort.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"423-433"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical Activation and Functional Connectivity Changes during Swallowing in Patients with Dysphagia in Lateral Medullary Syndrome.","authors":"Yi Li, Qiongshuai Zhang, Hui Wang, Le Wang, Ruyao Liu, Heping Li","doi":"10.1007/s00455-025-10892-6","DOIUrl":"10.1007/s00455-025-10892-6","url":null,"abstract":"<p><p>Swallowing function is affected in patients with lateral medullary syndrome (LMS) due to impaired swallowing central pattern generator, but it remains unclear whether their cortical function is affected. To determine the level of cortical involvement during swallowing in LMS dysphagia patients. This is a cross-sectional study carried out from May 2023 and January 2024 in China. 21 patients with LMS dysphagia and 20 age-matched healthy controls were recruited. Functional near-infrared spectroscopy with 39 channels was utilized to detect the cortical hemodynamic changes when repeated salivary swallowing. Cortical activation and functional connectivity during swallowing were analyzed. Compared with healthy subjects, patients with LMS demonstrated reduced activation in bilateral dorsolateral prefrontal cortex(DLPFC), left temporopolar area, frontopolar area(PFA), and right pre-motor and supplementary motor cortex(pSMC) (channel 11, P = 0.031; channel 12, P = 0.042; channel 15, P = 0.042; channel 19, P = 0.031; channel 24, P = 0.031; channel 25, P = 0.031). The activation of patients with LMS in right primary somatosensory cortex (PSC), supramarginal gyrus (SMG), FPA and left pars triangularis (PTG) was negatively correlated with the PAS score (channel1, P = 0.019; channel 2, P = 0.005; channel 23, P = 0.017; channel 27, P = 0.047). The activation in right PSC and SMG was negatively correlated with the stroke duration (channel 2, P = 0.026; channel 16, P = 0.018). There is no difference in the mean functional connectivity strength between the channels of patients with LMS and healthy subjects (P = 0.565). The functional connectivity strength between the bilateral temporopolar areas was reduced in patients with LMS compared with healthy subjects(P = 0.015). Although the lesion site of patients with LMS dysphagia is in the medulla oblongata, cortical activation and functional connectivity during swallowing differ from those of healthy subjects, which may be related to damage of the ascending sensory pathways and cortical-medullary diaschisis.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"443-453"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental and Computational Analysis of Bolus Fragmentation during Model Oropharyngeal Swallowing.","authors":"Steven McFarland, Dana M Leichter, Nicole Stark, Richard J Gilbert, Mark A Nicosia","doi":"10.1007/s00455-025-10899-z","DOIUrl":"10.1007/s00455-025-10899-z","url":null,"abstract":"<p><p>Fragmentation of the liquid bolus during swallowing may enhance the risk of airway exposure to the passing bolus and thereby increase vulnerability for aspiration. Our goal was to develop an experimental and a computational model that depicts how physical forces applied to a model bolus affect cohesion during simulated swallowing. A physical replica of the oral cavity was created through 3D printing to emulate the bolus-accommodating tongue within the oral cavity. The intent was to assess the effect of linear force applied to the bolus, similar to that of the deforming tongue during bolus propulsion through the acceleration and rapid deceleration of a pulley system, and to assess the ensuing degree of bolus fragmentation. Upon enaction of linear force applied to the contained bolus, a portion of the bolus characteristically fragmented and exited the device with measurable displacement velocity. Experimental and computational results demonstrated that the degree of bolus fragmentation increased as a function of bolus volume and velocity and decreased as a function of viscosity. We deduce that these physical attributes of the fluid bolus, when combined with the timing of laryngeal closure, pharyngeal peristalsis, and inspiratory air flow, contribute to an multi-component model of aspiration vulnerability during swallowing.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"483-492"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}