Is Swallowing of All Mixed Consistencies Dangerous for Penetration-Aspiration?

Lee KL, Kim WH, Kim EJ, Lee JK: Is swallowing of all mixed consistencies dangerous for penetration-aspiration? AmJ PhysMed Rehabil 2012;91:187Y192. Objective: The aim of this study was to determine whether the risk and severity of penetration-aspiration with mixed consistency (MIX), which consists of cooked rice and thin liquid barium (LIQUID), are different from the risks and severities with each single consistency (cooked rice or LIQUID) in dysphagic patients. Design: Dysphagic patients (N = 29) performed a videofluoroscopic swallowing study with the following foods: cooked rice, LIQUID, and MIX. Several components were analyzed using recorded videotapes. Results: The Penetration-Aspiration Scale score for MIX was significantly lower than that for LIQUID (P < 0.016). The location of the leading edge at the onset of a pharyngeal swallow between MIX and LIQUID was not different (P = 0.705). The pharyngeal delay time of LIQUID was delayed significantly compared with that of MIX (0.142 +/- 0.267 and -0.149 +/- 0.096 sec, respectively, P < 0.016). The severity of pharyngeal residue among the foods was different according to the location. Conclusions: Swallowing of MIX is not dangerous, and it is safer for not inducing penetration-aspiration as compared with the swallowing of LIQUID. The risk of penetration-aspiration may be judged depending on not only a food's consistency but also on various factors that affect airway protection, including the texture of food.