| D’Ottaviano, Filho, Andrade, Alves, Rocha, 2013, Brazil 17
|
Thickened - 5 and 10 ml (100 ml of water + 2 spoons of thickener);
Liquid - 5 and 10 ml;
Solid (½ cracker) |
Not reported |
Spoon |
Water, food thickener, cracker; blue dye |
- Posterior oral spillage; pharyngeal residue; laryngeal penetration; tracheal aspiration; the moment of tracheal aspiration; response to tracheal aspiration.
* The authors defined each parameter. |
Impairment of the oral preparatory phase: observation of posterior oral spillage of food; impairment of the oral phase: the presence of residue in valleculae; and impairment of the pharyngeal phase of swallowing: the presence of pharyngeal residue in pyriform sinus. |
| Ruopollo, Schettino, Frasca, Giacomelli, Prosperini, Cambieri, et al., 2013, Italy 18
|
Liquid - 3 ml;
Thickened - 2 ml |
Not reported |
Not reported |
Water, dye |
- Premature pharyngeal spillage of the food bolus; pharyngeal residue; laryngeal penetration.
* The authors did not define each parameter. |
Not reported |
| Luchesi, Kitamura, Mourão, 2014a, Brazil 19
|
Liquid - 3 ml and 7 ml;
Nectar - 3 ml and 7 ml
Honey - 3 ml and 7 ml
Pudding - 3 ml and 7 ml
Solid - (½ cornstarch biscuit) |
1 - Liquid and nectar in 4 offers: 3 ml, 3 ml, 7 ml, and 7 ml
2 - Honey in 4 offers: 3 ml, 3 ml, 7 ml, and 7 ml;
3 - Pudding in 2 tablespoons;
4 - Solid: ½ cornstarch biscuit. |
20 ml in syringe and tablespoon |
Lemonade, food thickener, cornstarch biscuit; green dye. |
- Salivary stasis; - Pharyngeal residue; - Laryngeal sensitivity; - Food aspiration.
* The authors did not define each parameter. |
The results were judged by two speech therapists and an otorhinolaryngologist, who classified dysphagia as level 0 to 3 according to the scale by Macedo Filho, Gomes, and Furkim (2000).
Individuals were divided into two groups according to dysphagia severity. |
| Luchesi, Kitamura, Mourão, 2014b, Brazil 20
|
Liquid - 3 ml and 7 ml;
Nectar - 3 ml and 7 ml Honey - 3 ml and 7 ml
Pudding - 3 ml and 7 ml
Solid - (½ cornstarch biscuit) |
1 - Liquid and nectar in 4 offers: 3 ml, 3 ml, 7 ml, and 7 ml
2 - Honey in 4 offers: 3 ml, 3 ml, 7 ml, and 7 ml;
3 - Pudding in 2 tablespoons;
4 - Solid: ½ biscuit. |
20 ml syringe and tablespoon |
Lemon juice, food thickener, cornstarch biscuit; green food dye |
Penetration and/or food aspiration.
* The authors defined each parameter. |
The FEES results were classified as the presence or absence of penetration and/or aspiration. The authors used FEES results to classify individuals according to the Functional Oral Intake Scale. |
| Fattori, Siciliano, Mancini, Bastiani, Bongioanni, Caldarazzo Ienco E, et al, 2016, Italy 21
|
Liquid - 5 ml
Semisolid - 5 ml
Solid - ¼ cup |
Not reported |
Not reported |
Water, gelatin, cream cracker, and methylene blue. |
The pharyngeal residue after swallowing; premature oral spillage; penetration and/or aspiration.
* The authors did not define each parameter. |
The Pharyngeal Residue Severity Scale was used for the analysis of pharyngeal residue after swallowing; premature oral spillage and penetration or aspiration were classified as present or absent. |
| Ruopollo, Onesti, Gori, 2016, Italy 22
|
Not reported |
Not reported |
Not reported |
Not reported |
Laryngeal sensitivity; Food residue.
* The authors did not define each parameter. |
The PAS scale and the Pharyngeal Residue Severity Scale. |
| Onesti, Schettino, Gori, Schettino, Frasca, Biasiotta A, et al, 2017, Italy 23
|
Puree - 5 ml, 10 ml, and 20 ml
Liquid - 5 ml, 10 ml, and 20 ml. |
Not reported |
Not reported |
Not reported |
Laryngeal adductor reflex; post-swallowing pharyngeal residue; penetration/aspiration.
* The authors did not define each parameter. |
The PAS scale and the Pharyngeal Residue Severity Scale. |
| Gozzer, Cola, Onofri, Merola, Silva, 2019, Brazil 24
|
Puree - 5ml
Thickened liquid - 5ml
Thin liquid - 5ml |
Not reported |
Not reported |
Not reported |
Posterior oral spillage, pharyngeal residue; penetration/aspiration. and laryngeal sensitivity. |
Posterior oral spillage was defined as the occurrence of anticipated oral spillage of the food bolus towards the hypopharynx beyond the area where the pharyngeal response should occur. Pharyngeal residues were defined as the permanence of contrasting material in the valleculae and pyriform sinus after the second deglutition. Laryngeal penetration was defined as the entire material being located above the vocal fold and laryngotracheal aspiration was defined as the passage of the material below the level of the vocal fold. |
| Pizzorni, Ginocchio, Bianchi, Feroldi, Vedrodyova, Mora, et al., 2020, Italy 25
|
Liquid - 5ml, 10ml, and 20ml
Semisolid - 5ml, 10ml, and 20ml
Solid - half cracker. |
liquids (3 × 5 ml, 3 × 10 ml, 3 × 20 ml), then semisolids (3 × 5 ml, 3 × 10 ml, 3 × 20 ml), and solids. |
Not reported |
Milk, apple sauce, and cracker. |
Pharyngeal residue, penetration, and aspiration. |
The PAS scale and the Yale Pharyngeal Residue Severity Rating Scale (>2 score = suggestive of the presence of clinically relevant residue) |
| Printza, Boziki, Triaridis, Kiousi, Arnaoutoglou, Constantinidis, et al, 2020, Greece 26
|
Liquids, semisolids, and solid Food.
Volume was not reported. |
Not reported |
Not reported |
Not reported |
Velopharyngeal sufficiency, pharyngeal squeeze, vocal cord movement/glottal closure, and pharyngeal-laryngeal secretions |
The PAS scale and the Yale Pharyngeal Residue Severity Rating Scale. Velopharyngeal sufficiency, pharyngeal squeeze, and vocal cord movement were rated as full, weak, or absent, and secretions were rated according to the Murray secretion scale from 0 to 3. |
| Mezzedimia, Vincib, Gianninic, Cocca. 2020, Italy 27
|
Thin Liquid - 5 ml.
Semisolid - 5 ml
Solid. |
Not reported |
Thin Liquid - spoon and cup.
Semisolid - spoon. |
Not reported |
Pharyngeal residue in valleculae and pyriform recesses. |
The Pooling-score. |
| Borges, Velasco, Ramos, Imamura, Roldão, Petrillo, et al, 2021, Brazil28
|
Liquid - 3, 5 and 10 mL
Thickened liquid - 3, 5 and 10 mL
Semi-solid - 3, 5 and 10 mL
Solid - ¼ of a cracker. |
Not reported. |
Not reported. |
Not reported for liquids and semi-solid.
Cracker for solid. |
Pharyngeal residue, penetration and aspiration.
* the authors did not provide a definition for each parameter. |
-The degree of dysphagia was divided into mild, moderate and severe, according to the classification by Macedo Filho, Gomes, and Furkim (2000). The result was categorized as normal (absence of dysphagia) and altered (presence of mild, moderate or severe dysphagia). |
| Adamske, Heyduck, Weidenmüller, Göricke, Frank, Olthoff, 2021, Germany29
|
Honey thickness - 5ml. |
An oral bolus of a teaspoon of green colored thickened water was applied to ensure a clear contrast to the tissues of the oropharyngeal tract. |
Teaspoon |
Water and green dye. |
Retention, Penetration and aspiration.
* the authors did not provide a definition for each parameter |
In addition to the Penetration-aspiration scale (score 1 to 8), the parameters leaking and retention (scores 0 to 3) were determined. |
| Mariani, Ruoppolo, Cilfone, Cocchi, Preziosi Standoli, Longo, et al, 2021, Italy, 30
|
Thin Liquid - <5ml, 5ml and 10ml.
Soft Liquid - 10ml. |
1. Two bolus of 5 ml soft liquid (yoghurt)
2. Bolus of <5 ml, 5 ml and 10 ml of thin liquid (milk)
Ask the patient to hold the bolus in their oral cavity and then each time to swallow upon the command of the operator according to the Langmore procedure. |
. Not reported. |
Yoghurt, Milk. |
Penetration and aspiration |
The PAS scale (absence of penetration/ aspiration, score 1; presence of penetration, score 2-5; and presence of aspiration, score 6-8). The cut-off point for the diagnosis of dysphagia was PAS≥3. The cut-off point for PEG indication was PAS≥6. Indeed, the indication for PEG placement was undertaken when the risk of aspiration was evident and urgent measures for alternative feeding had to be initiated to prevent the patient from developing further complications. |
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