Laryngeal penetration during deglutition in normal subjects of various ages

This study examined the frequency of penetration of liquid, paste, and masticated materials into the airway during videofluoroscopic studies of normal swallow in 98 normal subjects who were from 20 to 94 years of age. The purposes of the study were to define frequency and level of penetration using the penetration-aspiration scale as a result of age, bolus volume, viscosity, and gender, and to describe the body's sensorimotor response to the penetration based on audible coughs or throat clearing on the audio channel of each videotaped fluoroscopic study. Frequencies of penetration were defined in relation to bolus volume, age, gender, and bolus viscosity from swallows of 1, 3, 5, and 10 ml and cup-drinking of thin liquids; 3 ml of pudding; (1/4) of a Lorna Doone cookie; and a bite of an apple. Results showed that penetrations were significantly more frequent after age 50 and thick viscosities penetrated only in subjects age 50 and over. For persons under 50, 7.4% of swallows exhibited penetration, while for people age 50 and over, 16.8% of swallows showed penetration. Significantly more penetration occurred on larger liquid boluses. There was no relationship between gender and frequency of penetration. None of the subjects that penetrated showed a sensorimotor response to the penetration, which may relate to the relatively shallow depth of the penetration.