Evaluation of Hypopharyngeal Suction to Eliminate Aspiration

The Retro-Esophageal Suction (REScue) Catheter

Peter C Belafsky, O. B. Mehdizadeh, L. Ledgerwood, Maggie Kuhn

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 % (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 % (0/24 trials; p < 0.001), and suction through a 12-Fr catheter resulted in an aspiration rate of 33 % (2/6 trials; p > 0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p < 0.001). Mean UES opening improved from 0.0 (±0.0) mm in the control condition to 8.6 (±0.2) mm with a hypopharyngeal catheter (16 Fr Foley catheter; p < 0.001). Negative pressure applied through retro-esophageal suction catheters (>12 Fr) at the level of the UES reduced aspiration by 100 % and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalDysphagia
Volume30
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Upper Esophageal Sphincter
Suction
Catheters
Deglutition Disorders
Swallows
Pyriform Sinus
Safety
Barium
Cadaver
Esophagus
Outcome Assessment (Health Care)
Pressure
Incidence

Keywords

  • Aspiration
  • Deglutition
  • Deglutition disorders
  • Dysphagia
  • Endoscopy
  • Esophageal suction
  • Feeding tube
  • Oropharyngeal dysphagia (OPD)
  • Retro-esophageal suction
  • Suction
  • Surgery

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

Cite this

Evaluation of Hypopharyngeal Suction to Eliminate Aspiration : The Retro-Esophageal Suction (REScue) Catheter. / Belafsky, Peter C; Mehdizadeh, O. B.; Ledgerwood, L.; Kuhn, Maggie.

In: Dysphagia, Vol. 30, No. 1, 2015, p. 74-79.

Research output: Contribution to journalArticle

@article{bbfe8606259d46bc8673a37c9686dae4,
title = "Evaluation of Hypopharyngeal Suction to Eliminate Aspiration: The Retro-Esophageal Suction (REScue) Catheter",
abstract = "Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 {\%} (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 {\%} (0/24 trials; p < 0.001), and suction through a 12-Fr catheter resulted in an aspiration rate of 33 {\%} (2/6 trials; p > 0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p < 0.001). Mean UES opening improved from 0.0 (±0.0) mm in the control condition to 8.6 (±0.2) mm with a hypopharyngeal catheter (16 Fr Foley catheter; p < 0.001). Negative pressure applied through retro-esophageal suction catheters (>12 Fr) at the level of the UES reduced aspiration by 100 {\%} and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.",
keywords = "Aspiration, Deglutition, Deglutition disorders, Dysphagia, Endoscopy, Esophageal suction, Feeding tube, Oropharyngeal dysphagia (OPD), Retro-esophageal suction, Suction, Surgery",
author = "Belafsky, {Peter C} and Mehdizadeh, {O. B.} and L. Ledgerwood and Maggie Kuhn",
year = "2015",
doi = "10.1007/s00455-014-9576-z",
language = "English (US)",
volume = "30",
pages = "74--79",
journal = "Dysphagia",
issn = "0179-051X",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Evaluation of Hypopharyngeal Suction to Eliminate Aspiration

T2 - The Retro-Esophageal Suction (REScue) Catheter

AU - Belafsky, Peter C

AU - Mehdizadeh, O. B.

AU - Ledgerwood, L.

AU - Kuhn, Maggie

PY - 2015

Y1 - 2015

N2 - Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 % (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 % (0/24 trials; p < 0.001), and suction through a 12-Fr catheter resulted in an aspiration rate of 33 % (2/6 trials; p > 0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p < 0.001). Mean UES opening improved from 0.0 (±0.0) mm in the control condition to 8.6 (±0.2) mm with a hypopharyngeal catheter (16 Fr Foley catheter; p < 0.001). Negative pressure applied through retro-esophageal suction catheters (>12 Fr) at the level of the UES reduced aspiration by 100 % and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.

AB - Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 % (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 % (0/24 trials; p < 0.001), and suction through a 12-Fr catheter resulted in an aspiration rate of 33 % (2/6 trials; p > 0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p < 0.001). Mean UES opening improved from 0.0 (±0.0) mm in the control condition to 8.6 (±0.2) mm with a hypopharyngeal catheter (16 Fr Foley catheter; p < 0.001). Negative pressure applied through retro-esophageal suction catheters (>12 Fr) at the level of the UES reduced aspiration by 100 % and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.

KW - Aspiration

KW - Deglutition

KW - Deglutition disorders

KW - Dysphagia

KW - Endoscopy

KW - Esophageal suction

KW - Feeding tube

KW - Oropharyngeal dysphagia (OPD)

KW - Retro-esophageal suction

KW - Suction

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=84925517732&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925517732&partnerID=8YFLogxK

U2 - 10.1007/s00455-014-9576-z

DO - 10.1007/s00455-014-9576-z

M3 - Article

VL - 30

SP - 74

EP - 79

JO - Dysphagia

JF - Dysphagia

SN - 0179-051X

IS - 1

ER -