Quantifying Pharyngeal Residue Across the Adult Life Span: Normative Values by Age, Gender, and Swallow Task

Area of Science:

• Swallowing physiology and biomechanics.
• Quantitative analysis of anatomical and physiological data.

Background:

• Pharyngeal residue assessment is crucial for understanding swallowing function.
• Normative data on pharyngeal residue in healthy adults is limited.
• Pixel-based quantification offers objective residue measurement.

Purpose of the Study:

• To quantify pharyngeal residue in a normative dataset using pixel-based methods.
• To examine the influence of age, gender, and swallow task on pharyngeal residue.
• To establish reliability of residue measures and explore predictors of residue presence and amount.

Main Methods:

• 195 healthy participants underwent videofluoroscopic swallow studies (VFSS) using the Modified Barium Swallow Impairment Profile (MBSImP) protocol.
• ImageJ software computed Normalized Residue Ratio Scale and Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) pharyngeal residue measures.
• Statistical analyses included descriptive statistics, logistic regression, generalized linear mixed models, and Spearman rho correlation.

Main Results:

• The majority of swallows (76.2%) showed no pharyngeal residue.
• Residue presence was significantly influenced by older age, male gender, thicker liquid viscosity, and larger volumes (cup sip).
• When residue was present (23.8%), amounts were low and primarily associated with increasing age, with incremental increases per year.

Conclusions:

• Pharyngeal residue is minimal in healthy adults.
• While age, gender, and task influence residue presence, only age correlates with increased residue amount when present.
• These findings contribute normative data and highlight age as a key factor in pharyngeal residue quantification.