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The Association of 3-D Volume and 2-D Area of Post-swallow Pharyngeal Residue on CT Imaging

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Abstract

Pharyngeal residue, the material that remains in the pharynx after swallowing, is an important marker of impairments in swallowing and prandial aspiration risk. The goals of this study were to determine whether the 2D area of post-swallow residue accurately represents its 3D volume, and if the laterality of residue would affect this association. Thirteen patients with dysphagia due to brainstem stroke completed dynamic 320-detector row computed tomography while swallowing a trial of 10 ml honey-thick barium. 3D volumes of pharyngeal residue were compared to 2D lateral and anterior–posterior areas, and a laterality index for residue location was computed. Although the anteroposterior area of residue was larger than the lateral area, the two measures were positively correlated with one another and with residue volume. On separate bivariate regression analyses, residue volume was accurately predicted by both lateral (R2 = 0.91) and anteroposterior (R2 = 0.88) residue areas, with limited incidence of high residuals. Half of the sample demonstrated a majority of pharyngeal residue lateralized to one side of the pharynx, with no effect of laterality on the association between areas and volume. In conclusion, the area of post-swallow pharyngeal residue was associated with volume, with limitations in specific cases. Direct measurement of pharyngeal residue volume and swallowing physiology with 3D-CT can be used to validate results from standard 2D instrumentation.

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Acknowledgements

The research reported in this paper was partially supported. The authors would like to thank the staff of Fujita Health University Hospital, Department of Radiology, for their generous support and assistance with CT imaging and data collection.

Funding

This research was partially supported by JSPS KAKENHI (No. 25750236 Inamoto) and by the National Institute of Child Health and Human Development- National Center for Medical Rehabilitation Research through award 5T32HD007414-23 (Mulheren); the content is solely the responsibility of the authors and does not necessarily represent the views the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA

    Rachel W. Mulheren

  2. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Rachel W. Mulheren, Charles A. Odonkor, Marlis Gonzalez-Fernandez & Jeffrey B. Palmer

  3. Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, USA

    Rachel W. Mulheren

  4. Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan

    Yoko Inamoto

  5. Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, 470-1192, Japan

    Yoko Inamoto, Yuriko Ito, Seiko Shibata, Hitoshi Kagaya & Eiichi Saitoh

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  1. Rachel W. Mulheren
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Correspondence to Yoko Inamoto.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mulheren, R.W., Inamoto, Y., Odonkor, C.A. et al. The Association of 3-D Volume and 2-D Area of Post-swallow Pharyngeal Residue on CT Imaging. Dysphagia 34, 665–672 (2019). https://doi.org/10.1007/s00455-018-09968-3

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  • DOI: https://doi.org/10.1007/s00455-018-09968-3

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