Can an Oral Mechanism Examination Contribute to the Assessment of Odds of Aspiration?
Use of an oral mechanism examination is ubiquitous and long-standing despite a paucity of research supporting its clinical utility in dysphagia diagnostics. The purpose of this study was to investigate whether components of an oral mechanism examination, i.e., binary judgments (complete/incomplete)...
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| Veröffentlicht in: | Dysphagia 2013-09, Vol.28 (3), p.370-374 |
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| creator | Leder, Steven B. Suiter, Debra M. Murray, Joseph Rademaker, Alfred W. |
| description | Use of an oral mechanism examination is ubiquitous and long-standing despite a paucity of research supporting its clinical utility in dysphagia diagnostics. The purpose of this study was to investigate whether components of an oral mechanism examination, i.e., binary judgments (complete/incomplete) of labial closure, lingual range of motion, and facial symmetry, were associated with increased odds of aspiration as confirmed by subsequent instrumental testing. Study design was a single-group consecutively referred case series with a single judge. A total of 4,102 consecutive inpatients from a large, urban, tertiary-care teaching hospital were accrued, with 3,919 meeting the inclusion criterion of adequate cognitive ability to participate in an oral mechanism examination followed immediately by a fiberoptic endoscopic evaluation of swallowing. Stepwise multiple logistic regression analysis indicated that participants with incomplete lingual range of motion had an odds of aspiration that was 2.72 times the odds of aspiration of those with complete lingual range of motion (95 % confidence interval [CI] = 1.96–3.79,
p
0.05). New and clinically relevant information was found for lingual range of motion and facial symmetry, i.e., when incomplete, the clinician should be alerted to potential increased odds of aspiration during subsequent instrumental dysphagia testing. |
| doi_str_mv | 10.1007/s00455-012-9442-9 |
| format | Article |
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p
< 0.0001), and incomplete lingual range of motion was an independent risk factor for aspiration regardless of labial closure and facial symmetry. Participants with incomplete facial symmetry had an odds of aspiration that was 0.76 times the odds of aspiration of those with complete facial symmetry (95% CI = 0.61–0.95,
p
= 0.017). Isolated incomplete labial closure did not affect the odds of aspiration (
p
> 0.05). New and clinically relevant information was found for lingual range of motion and facial symmetry, i.e., when incomplete, the clinician should be alerted to potential increased odds of aspiration during subsequent instrumental dysphagia testing.</description><identifier>ISSN: 0179-051X</identifier><identifier>EISSN: 1432-0460</identifier><identifier>DOI: 10.1007/s00455-012-9442-9</identifier><identifier>PMID: 23292501</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Child ; Child, Preschool ; Endoscopy ; Equipment and supplies ; Facial Asymmetry - physiopathology ; Female ; Fiber optics ; Gastroenterology ; Hepatology ; Humans ; Imaging ; Lip - physiopathology ; Male ; Medical colleges ; Medicine ; Medicine & Public Health ; Middle Aged ; Observer Variation ; Original Article ; Otorhinolaryngology ; Physical Examination ; Radiology ; Respiratory Aspiration - diagnosis ; Risk Assessment ; Single-Blind Method ; Tongue - physiopathology ; Young Adult</subject><ispartof>Dysphagia, 2013-09, Vol.28 (3), p.370-374</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>COPYRIGHT 2013 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-88e84403b45641caf51466452949f3e995c62f3f597d7ce4d2691a3c047f5bfd3</citedby><cites>FETCH-LOGICAL-c439t-88e84403b45641caf51466452949f3e995c62f3f597d7ce4d2691a3c047f5bfd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00455-012-9442-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00455-012-9442-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23292501$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leder, Steven B.</creatorcontrib><creatorcontrib>Suiter, Debra M.</creatorcontrib><creatorcontrib>Murray, Joseph</creatorcontrib><creatorcontrib>Rademaker, Alfred W.</creatorcontrib><title>Can an Oral Mechanism Examination Contribute to the Assessment of Odds of Aspiration?</title><title>Dysphagia</title><addtitle>Dysphagia</addtitle><addtitle>Dysphagia</addtitle><description>Use of an oral mechanism examination is ubiquitous and long-standing despite a paucity of research supporting its clinical utility in dysphagia diagnostics. The purpose of this study was to investigate whether components of an oral mechanism examination, i.e., binary judgments (complete/incomplete) of labial closure, lingual range of motion, and facial symmetry, were associated with increased odds of aspiration as confirmed by subsequent instrumental testing. Study design was a single-group consecutively referred case series with a single judge. A total of 4,102 consecutive inpatients from a large, urban, tertiary-care teaching hospital were accrued, with 3,919 meeting the inclusion criterion of adequate cognitive ability to participate in an oral mechanism examination followed immediately by a fiberoptic endoscopic evaluation of swallowing. Stepwise multiple logistic regression analysis indicated that participants with incomplete lingual range of motion had an odds of aspiration that was 2.72 times the odds of aspiration of those with complete lingual range of motion (95 % confidence interval [CI] = 1.96–3.79,
p
< 0.0001), and incomplete lingual range of motion was an independent risk factor for aspiration regardless of labial closure and facial symmetry. Participants with incomplete facial symmetry had an odds of aspiration that was 0.76 times the odds of aspiration of those with complete facial symmetry (95% CI = 0.61–0.95,
p
= 0.017). Isolated incomplete labial closure did not affect the odds of aspiration (
p
> 0.05). New and clinically relevant information was found for lingual range of motion and facial symmetry, i.e., when incomplete, the clinician should be alerted to potential increased odds of aspiration during subsequent instrumental dysphagia testing.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Endoscopy</subject><subject>Equipment and supplies</subject><subject>Facial Asymmetry - physiopathology</subject><subject>Female</subject><subject>Fiber optics</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Lip - physiopathology</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Original Article</subject><subject>Otorhinolaryngology</subject><subject>Physical Examination</subject><subject>Radiology</subject><subject>Respiratory Aspiration - diagnosis</subject><subject>Risk Assessment</subject><subject>Single-Blind Method</subject><subject>Tongue - physiopathology</subject><subject>Young Adult</subject><issn>0179-051X</issn><issn>1432-0460</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV1rFDEUhoNY7Fr9Ad5IwBtvpuZzZnIly1KrUNmbFrwL2cxJmzKTrEkG6r830239wpKQA8nzvpyTF6E3lJxSQroPmRAhZUMoa5QQ9XiGVlRw1hDRkudoRWinGiLpt2P0MudbUkHV8hfomHGmmCR0ha42JuC6t8mM-CvYGxN8nvDZnZl8MMXHgDcxlOR3cwFcIi43gNc5Q84ThIKjw9thyEtd571P95KPr9CRM2OG1w_1BF19OrvcfG4utudfNuuLxgquStP30AtB-E7IVlBrnKSibYVkSijHQSlpW-a4k6obOgtiYK2ihlsiOid3buAn6P3Bd5_i9xly0ZPPFsbRBIhz1lSwvusol7Ki7_5Bb-OcQu2uUlxQqlTPf1PXZgTtg4slGbuY6nVXf692Qhav0_9QdQ0weRsDOF_v_xLQg8CmmHMCp_fJTyb90JToJUp9iFLXhPQSpVZV8_ah4Xk3wfBL8ZhdBdgByPUpXEP6Y6InXX8CVl2lSg</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Leder, Steven B.</creator><creator>Suiter, Debra M.</creator><creator>Murray, Joseph</creator><creator>Rademaker, Alfred W.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Can an Oral Mechanism Examination Contribute to the Assessment of Odds of Aspiration?</title><author>Leder, Steven B. ; Suiter, Debra M. ; Murray, Joseph ; Rademaker, Alfred W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-88e84403b45641caf51466452949f3e995c62f3f597d7ce4d2691a3c047f5bfd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Endoscopy</topic><topic>Equipment and supplies</topic><topic>Facial Asymmetry - physiopathology</topic><topic>Female</topic><topic>Fiber optics</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Lip - physiopathology</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Original Article</topic><topic>Otorhinolaryngology</topic><topic>Physical Examination</topic><topic>Radiology</topic><topic>Respiratory Aspiration - diagnosis</topic><topic>Risk Assessment</topic><topic>Single-Blind Method</topic><topic>Tongue - physiopathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leder, Steven B.</creatorcontrib><creatorcontrib>Suiter, Debra M.</creatorcontrib><creatorcontrib>Murray, Joseph</creatorcontrib><creatorcontrib>Rademaker, Alfred W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Dysphagia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leder, Steven B.</au><au>Suiter, Debra M.</au><au>Murray, Joseph</au><au>Rademaker, Alfred W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can an Oral Mechanism Examination Contribute to the Assessment of Odds of Aspiration?</atitle><jtitle>Dysphagia</jtitle><stitle>Dysphagia</stitle><addtitle>Dysphagia</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>28</volume><issue>3</issue><spage>370</spage><epage>374</epage><pages>370-374</pages><issn>0179-051X</issn><eissn>1432-0460</eissn><abstract>Use of an oral mechanism examination is ubiquitous and long-standing despite a paucity of research supporting its clinical utility in dysphagia diagnostics. The purpose of this study was to investigate whether components of an oral mechanism examination, i.e., binary judgments (complete/incomplete) of labial closure, lingual range of motion, and facial symmetry, were associated with increased odds of aspiration as confirmed by subsequent instrumental testing. Study design was a single-group consecutively referred case series with a single judge. A total of 4,102 consecutive inpatients from a large, urban, tertiary-care teaching hospital were accrued, with 3,919 meeting the inclusion criterion of adequate cognitive ability to participate in an oral mechanism examination followed immediately by a fiberoptic endoscopic evaluation of swallowing. Stepwise multiple logistic regression analysis indicated that participants with incomplete lingual range of motion had an odds of aspiration that was 2.72 times the odds of aspiration of those with complete lingual range of motion (95 % confidence interval [CI] = 1.96–3.79,
p
< 0.0001), and incomplete lingual range of motion was an independent risk factor for aspiration regardless of labial closure and facial symmetry. Participants with incomplete facial symmetry had an odds of aspiration that was 0.76 times the odds of aspiration of those with complete facial symmetry (95% CI = 0.61–0.95,
p
= 0.017). Isolated incomplete labial closure did not affect the odds of aspiration (
p
> 0.05). New and clinically relevant information was found for lingual range of motion and facial symmetry, i.e., when incomplete, the clinician should be alerted to potential increased odds of aspiration during subsequent instrumental dysphagia testing.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23292501</pmid><doi>10.1007/s00455-012-9442-9</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Analysis Child Child, Preschool Endoscopy Equipment and supplies Facial Asymmetry - physiopathology Female Fiber optics Gastroenterology Hepatology Humans Imaging Lip - physiopathology Male Medical colleges Medicine Medicine & Public Health Middle Aged Observer Variation Original Article Otorhinolaryngology Physical Examination Radiology Respiratory Aspiration - diagnosis Risk Assessment Single-Blind Method Tongue - physiopathology Young Adult |
| title | Can an Oral Mechanism Examination Contribute to the Assessment of Odds of Aspiration? |
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