Reference Values for Videofluoroscopic Measures of Swallowing: An Update

Area of Science:

• Speech and Hearing Sciences
• Clinical Diagnostics
• Swallowing Physiology

Background:

• Videofluoroscopic swallowing study (VFSS) is crucial for diagnosing swallowing impairments.
• Current VFSS diagnostic judgments show poor reliability, highlighting the need for standardized benchmarks.
• Previous reference data for healthy adults was limited to those under 60 years.

Purpose of the Study:

• To establish comprehensive reference percentiles for quantitative VFSS measures in healthy adults.
• To extend previous research by including a broader age range of participants.
• To improve the accuracy and consistency of VFSS interpretations in clinical practice.

Main Methods:

• Collected data on 16 VFSS parameters from 78 healthy adults (aged 21-82).
• Participants consumed barium of varying viscosities (thin to extremely thick).
• Analyzed recordings using the ASPEKT Method, determining reference percentiles per CLSI guidelines.

Main Results:

• Presented VFSS reference percentile tables for timing parameters and pixel-based kinematic measures.
• Included data on swallow reaction time, UES opening, laryngeal vestibule closure, pharyngeal area, residue, and hyoid kinematics.
• Proposed clinical decision limits to identify atypical swallowing values.

Conclusions:

• Updated reference percentiles and decision limits aim to enhance VFSS interpretation reliability.
• These benchmarks support clinicians in accurate diagnosis and decision-making.
• The study provides essential data for advancing the clinical application of VFSS.