A penetration-aspiration scale. The development and use of an 8-point, equal-appearing interval scale to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled.
What is the Penetration Aspiration Scale (PAS)?
The penetration-aspiration scale (PAS) score was graded from 1 to 8 points. [22] Score 1 indicates "material does not enter airway". Score 2 points out "material enters the airway, remains above the vocal folds, and is ejected from the airway". ...
What is the difference between penetration and aspiration?
The term aspiration is used for material that passes inferior to the level of the vocal folds. If material enters the larynx but remains above the vocal folds this is called penetration. John C Rosenbek et al. introduced the eight point scale in their 1996 article 1,2.
What is the 9-point Penetration-Aspiration Scale?
The original 9-Point Penetration-Aspiration Scale 1. Material does not enter the airway 2. Material enters the airway, remains above the vocal folds, and is ejected from the airway 3. Material enters the airway, remains above the vocal folds, and is not ejected from the airway 4.
How are penetration and aspiration event scores determined?
The development and use of an 8-point, equal-appearing interval scale to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled.
What does the penetration aspiration scale measure?
A widely applied metric for identifying and rating the severity of penetration and aspiration events during MBSS is the Penetration–Aspiration Scale (PAS) [13]. The PAS is a rank ordered scale that classifies the depth of penetrated or aspirated material and the patient's response to airway invasion.
What is penetration aspiration?
At the beginning of evaluation, the clinician's main concern is the presence of aspiration or penetration. Aspiration is defined as the passing of the bolus below the true vocal folds, and penetration is when the bolus enters the airway but not below the true vocal folds.
What does penetration mean in dysphagia?
Penetration is when food or liquid goes into the trachea and stays above the vocal cords. Aspiration is when food or liquid goes into the trachea and goes below the vocal cords.
What scale is used to describe the level of penetration and aspiration of material and what evaluation is this scale often used with?
The 8-point Penetration-Aspiration Scale (PAS) was introduced to the field of dysphagia in 1996 and has become the standard method used by both clinicians and researchers to describe and measure the severity of airway invasion during swallowing.
How do you determine dysphagia severity?
The Dysphagia Outcome and Severity Scale (DOSS) is a simple, easy-to-use, 7-point scale developed to systematically rate the functional severity of dyspha- gia based on objective assessment and make recommen- dations for diet level, independence level, and type of nutrition.
What is penetration on barium swallow?
The term aspiration is used for material that passes inferior to the level of the vocal folds. If material enters the larynx but remains above the vocal folds this is called penetration.
What is definition of penetration?
Definition of penetration 1a : the power to penetrate especially : the ability to discern deeply and acutely. b : the depth to which something penetrates. c : the extent to which a commercial product or agency is familiar or sells in a market. 2 : the act or process of penetrating: such as.
What causes penetration in swallowing?
Abstract. Glottal closure during the pharyngeal phase of swallowing is one of the important steps in protecting the airway. Generally, it is believed that any deficiency in this process can lead to laryngeal penetration and aspiration.
What is laryngeal penetration without aspiration?
Laryngeal penetration occurs when food or liquids enters the top of the airway (the voice box/ larynx). Aspiration occurs when food or liquids enters the lower airway (below the level of the vocal cords in the larynx). Choking occurs when a food (or another object) physically blocks the airway.
What is the Doss scale?
The Dysphagia Outcome and Severity Scale (DOSS) is a simple, easy-to-use, 7-point scale developed to systematically rate the functional severity of dysphagia based on objective assessment and make recommendations for diet level, independence level, and type of nutrition.
What is the functional dysphagia scale?
The Functional Dysphagia Scale Is a Useful Tool for Predicting Aspiration Pneumonia in Patients With Parkinson Disease - PMC. An official website of the United States government.
What is the difference between fees and MBS?
A similar test is the modified barium swallow study (MBS). This uses fluorosocopy (X-rays) to view your swallowing. One of the advantages of the FEES over the MBS is that the FEES test does not expose you to any radiation. And unlike the MBS, a FEES may be done in an office or clinic, instead of a hospital.
What causes penetration in swallowing?
Abstract. Glottal closure during the pharyngeal phase of swallowing is one of the important steps in protecting the airway. Generally, it is believed that any deficiency in this process can lead to laryngeal penetration and aspiration.
What is laryngeal penetration without aspiration?
Laryngeal penetration occurs when food or liquids enters the top of the airway (the voice box/ larynx). Aspiration occurs when food or liquids enters the lower airway (below the level of the vocal cords in the larynx). Choking occurs when a food (or another object) physically blocks the airway.
What does deep laryngeal penetration mean?
Aspiration is defined as passage of materials through the vocal folds, and laryngeal penetration is defined as passage of materials into the larynx, but not through the vocal folds.
What does it mean to aspirate after drinking?
Usually when a person eats or drinks, the food or liquid moves from the mouth into the throat and down through the esophagus, or food pipe, into the stomach. Pulmonary aspiration occurs when the substance accidentally passes into the windpipe and lungs instead of the esophagus.
First task
The first task was to write down all possible observations from VF imaging data that involve swallowed material entering the airway.
Second Task
Next, the authors sought to develop an unequivocal, objective rationale for each observation, and began by asking a series of questions.
Final task
To arrive at a scale that describes which of these events are worse than others, the investigators ranked the various combinations of events in ascending order of severity, indicating where each score should be placed relative to the others.
Application
Can a standardized scale differentiate normal from abnormal? We compared PA scale scores of thin-liquid swallows of two groups of patients—15 with stroke and 16 after treatment for head and neck cancer—to a healthy cohort. Six patients with stroke aspirated (all PA scale scores 7 and 8).
Author Notes
James L. Coyle, PhD, CCC-SLP, BCS-S, is associate professor in the departments of Communication Science and Disorders and Otolaryngology at the University of Pittsburgh. He is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders (Dysphagia). [email protected]
What is OD in phoniatrics?
PurposeOropharyngeal dysphagia (OD) is a common phenomenon in otorhinolaryngology and phoniatrics. As both sub-disciplines have a strong tradition and clinical experience in endoscopic assessment of the upper aerodigestive tract, the implementation of fiberoptic endoscopic evaluation of swallowing (FEES) was an almost self-evident evolution. This review aims to provide an update on FEES and the role of phoniatricians and otorhinolaryngologists using FEES in Europe.MethodsA narrative review of the literature was performed by experts in the field of FEES both in the clinical context and in the field of scientific research.ResultsFEES is the first-choice OD assessment technique for both phoniatricians and otorhinolaryngologists. FEES is becoming increasingly popular because of its usefulness, safety, low costs, wide applicability, and feasibility in different clinical settings. FEES can be performed by health professionals of varying disciplines, once adequate knowledge and skills are acquired. FEES aims to determine OD nature and severity and can provide diagnostic information regarding the underlying etiology. The direct effect of therapeutic interventions can be evaluated using FEES, contributing to design the OD management plan. Standardization of FEES protocols and metrics is still lacking. Technological innovation regarding image resolution, frame rate frequency, endoscopic light source specifications, and endoscopic rotation range has contributed to an increased diagnostic accuracy.Conclusion The rising number of phoniatricians and otorhinolaryngologists performing FEES contributes to the early detection and treatment of OD in an aging European population. Nevertheless, a multidisciplinary approach together with other disciplines is crucial for the success of OD management.
What is the risk of dysphagia after surgery?
Patients with head and neck cancers are at risk of developing dysphagia post treatment, related to surgery, radiotherapy and/or chemoradiotherapy. This can be a distressing and debilitating symptom and requires assessment with a multidisciplinary approach, often led by speech and language therapists. Initially, the case must be clinician-evaluated, taking into account the nature of the oncological treatment, and also utilise patient-reported outcome measures. Multiple assessment tools are then available, including instrumental evaluation of swallowing such as Fibreoptic Endoscopic Evaluation of Swallowing and Video-fluoroscopy swallow. This chapter reviews the tools utilised in assessing and managing dysphagia in patients post chemoradiotherapy, post surgery for oral cavity, oropharyngeal and laryngeal cancers. Understanding of the prior treatment and resultant altered anatomy with a tailored management approach for individual cases is recommended to optimise patient outcomes.
What are the criteria for VFSS?
The VFSS criteria included definite presence of aspiration (defined as a penetration-aspiration scale [PAS] score ≥6) or presence of penetration (2≤ PAS score ≤5) with residual material at the vallecular pouch or pyriformis sinus to prevent ceiling effects. 22 Patients who had severe cognitive dysfunction who could not perform 1-step follow commands, serious psychiatric disorders, cervical surgery, respiratory difficulties, allergic reactions to electrodes of NMES, and those who were pregnant or breast-feeding were excluded. As this study evaluates the compensatory applications between the 4-channel NMES and sham groups, there were no restrictions with regard to the stage of dysphagia and hospital settings. ...
How many subjects were in the modified barium swallow study?
The test-retest variability of the modified barium swallow study using videofluoroscopy was analyzed. Sixteen normal subjects (8 men, 8 women) were organized into 2 age groups: middle-aged group (mean, 45 years) and old-age group (mean, 66 years). Nine durational measures of the swallow were evaluated. There were no statistically significant differences for any of the measures between the initial test and a retest conducted days later. The findings suggest that, on the whole, normal subjects perform similarly on test and a retest. However, the variability displayed by these normal subjects may be clinically significant, indicating that test-retest swallowing duration measures require careful interpretation.
How is the 8 point interval scale used?
The development and use of an 8-point, equal-appearing interval scale to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled. Intra- and interjudge reliability have been established. Clinical and scientific uses of the scale are discussed.
What is the definition of aspiration?
the definition. Aspiration is defined as passage of material
What is the name of the hospital in Wisconsin?
ans Hospital and the University of Wisconsin Clinical Science Center.
