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Tarar ZI, Farooq U, Bechtold ML, Ghouri YA. Cap-assisted endoscopy for esophageal foreign bodies: A meta-analysis. World J Meta-Anal 2023; 11:238-246. [DOI: 10.13105/wjma.v11.i5.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Esophageal foreign bodies are common around the world. Newer approaches, such as cap-assisted endoscopy, have been introduced as an alternative to conventional methods. Therefore, we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.
AIM To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.
METHODS An extensive literature search was performed (December 2021). For esophageal foreign body removal, cap-assisted endoscopy was compared to conventional endoscopy for procedure time, technical success of the procedure, time of foreign body retrieval, en bloc removal, and adverse event rate using odds ratio and mean difference.
RESULTS Six studies met the inclusion criteria (n = 1305). Higher odds of technical success (P = 0.002) and en bloc removal (P < 0.01) and lower odds of adverse events (P = 0.02) and foreign body removal time (P < 0.01) were observed with cap-assisted endoscopy as compared to conventional techniques.
CONCLUSION For esophageal foreign bodies, the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.
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Affiliation(s)
- Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Umer Farooq
- Department of Medicine, Loyola University, Chicago, IL 60153, United States
| | - Matthew L Bechtold
- Department of Medicine, University of Missouri - Columbia, Columbia, MO 65212, United States
| | - Yezaz A Ghouri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
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Gangwani MK, Aziz M, Dahiya DS, Aziz A, Priyanka F, Karna R, Lee-Smith W, Ahmed Z, Kamal F, Inamdar S, Alastal Y, Adler D. Comparable Efficacy for Push Versus Pull Technique in Esophageal Food Impaction: Systematic Review with Meta-Analysis. Dig Dis Sci 2023:10.1007/s10620-023-07988-0. [PMID: 37278950 DOI: 10.1007/s10620-023-07988-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Esophageal food impaction (EFI) is a common GI emergency. Push and pull methods are used currently for EFI retrieval. We aim to review current available literature to compare success rates and evaluate adverse event rates of the two techniques. METHODS A comprehensive literature search was performed using MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, KCI-Korean Journal Index, SciELO and Global Index Medicus. Odds ratio (OR) with 95% confidence interval (CI) was calculated when comparing the dichotomous variables. We aimed to evaluate technical success and adverse events for EFI comparing push and pull technique on single arm and comparator analysis. RESULTS The search strategy yielded a total of 126 articles. 18 studies with 3528 participants were included. The technical success rate was 97.5% (CI 96.6-99.2%) in the push and 88.4% (CI 72.8-98.7%) in the pull technique with no statistical difference on comparator analysis. Overall rate of adverse events was 4.03% (CI 0.9-5.0%) in the push technique and 2.22% (CI 0-2.9%) in the pull technique with no statistical difference on comparator analysis (OR 95% CI 0.464-2.782, p = 0.78, I2 = 31.54%). There was no statistical difference between rate of lacerations and perforations either between the two techniques. CONCLUSION Both techniques have acceptable clinical outcomes which appear within standard of care. Operator experience and individual clinical scenarios should guide decision-making regarding technique selection.
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Affiliation(s)
| | - Muhammad Aziz
- Department of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, 43614, USA
| | - Dushyant Singh Dahiya
- Department of Medicine, Central Michigan University College of Medicine, Saginaw, MI, 48603, USA
| | - Abeer Aziz
- Department of Gastroenterology and Hepatology, Augusta University, Augusta, GA, USA
| | - Fnu Priyanka
- Division of Medicine, Shaheed Mohtarma Benazir Bhutto University, Larkana, Pakistan
| | - Rahul Karna
- Department of Medicine, Alleghany General Hospital, Pittsburgh, PA, USA
| | - Wade Lee-Smith
- University of Toledo Libraries, University of Toledo, Toledo, OH, USA
| | - Zohaib Ahmed
- Department of Medicine, University of Toledo Medical Center, Toledo, OH, 43614, USA
| | - Faisal Kamal
- Digestive Health Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - Sumant Inamdar
- Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yaseen Alastal
- Department of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, 43614, USA
| | - Douglas Adler
- Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Center Health, Denver, CO, 80210, USA.
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Tarar ZI, Farooq U, Bechtold ML, Ghouri YA. Cap-assisted endoscopy for esophageal foreign bodies: A meta-analysis. World J Meta-Anal 2023; 11:38-46. [DOI: 10.13105/wjma.v11.i1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/11/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Esophageal foreign bodies are common around the world. Newer approaches, such as cap-assisted endoscopy, have been introduced as an alternative to conventional methods. Therefore, we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.
AIM To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.
METHODS An extensive literature search was performed (December 2021). For esophageal foreign body removal, cap-assisted endoscopy was compared to conventional endoscopy for procedure time, technical success of the procedure, time of foreign body retrieval, en bloc removal, and adverse event rate using odds ratio and mean difference.
RESULTS Six studies met the inclusion criteria (n = 1305). Higher odds of technical success (P = 0.002) and en bloc removal (P < 0.01) and lower odds of adverse events (P = 0.02) and foreign body removal time (P < 0.01) were observed with cap-assisted endoscopy as compared to conventional techniques.
CONCLUSION For esophageal foreign bodies, the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.
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Affiliation(s)
- Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States
| | - Umer Farooq
- Department of Medicine, Loyola University, Chicago, IL 60153, United States
| | - Matthew L Bechtold
- Department of Medicine, University of Missouri - Columbia, Columbia, MO 65212, United States
| | - Yezaz A Ghouri
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States
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Ahmed Z, Arif SF, Ong SL, Badal J, Lee-Smith W, Renno A, Alastal Y, Nawras A, Aziz M. Cap-Assisted Endoscopic Esophageal Foreign Body Removal Is Safe and Efficacious Compared to Conventional Methods. Dig Dis Sci 2022; 68:1411-1425. [PMID: 36350475 DOI: 10.1007/s10620-022-07741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Esophageal foreign body impaction (FBI) is a commonly encountered gastrointestinal emergency requiring immediate intervention. Foreign bodies can be composed of food, commonly referred to as a "food bolus" (FB), or other matter (non-food). We aim to conduct systematic review and meta-analysis to compare cap-assisted and conventional endoscopic techniques for removal of esophageal FBI. METHODS A comprehensive search technique was utilized to identify studies that used capped endoscopic devices to remove FB or other esophageal foreign bodies. The primary outcomes were the technical success rate, rate of en bloc retrieval, and procedure time. Secondary outcomes were overall adverse events, bleeding, mucosal tears, and perforation. RESULTS Seven studies with a total of 1407 patients were included. The mean patient age was 55.3 (SD ± 7.2) years and 44.8% of patients were male. There were two RCTs and five observational studies among the included studies. The technical success rate was significantly higher in the cap-assisted group compared to the conventional group (OR 3.47, CI 1.68-7.168, I2 = 0%, p = < 0.001), as well as the en bloc retrieval rate (OR 26.90, CI 17.82-40.60, I2 = 0%, p = 0.001). There was a trend towards lower procedural time for the cap-assisted group compared to the conventional group, although the difference did not reach statistical significance (MD - 10.997, CI - 22.78-0.786, I2 = 99.9%, p = 0.06). The overall adverse events were significantly lower in the cap-assisted group compared to the conventional group (OR 0.118, CI 0.018-0.792, I2 = 81.79%, p = 0.02). CONCLUSION The cap-assisted technique has improved efficacy and safety. To confirm these results, larger randomized trials are warranted.
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Affiliation(s)
- Zohaib Ahmed
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, USA.
| | | | - Stephanie Lin Ong
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Joyce Badal
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Wade Lee-Smith
- University of Toledo Libraries, University of Toledo, Toledo, OH, USA
| | - Anas Renno
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| | - Yaseen Alastal
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| | - Ali Nawras
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
| | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, USA
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Jackson R, Chabrillac E, Bell A, Edafe O. Rigid versus flexible endoscopy for managing ingested foreign bodies-can we improve pathways? Eur Arch Otorhinolaryngol 2022. [PMID: 35122508 DOI: 10.1007/s00405-022-07285-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE This study aims to evaluate management pathways, outcomes and safety of rigid endoscopy (RE) and flexible endoscopy (FE) for the treatment of impacted foreign bodies of the upper gastrointestinal tract (UGIT) in adults. METHODS Retrospective study, included all patients undergoing RE or FE for impacted UGIT foreign body over an 11-year-period. RESULTS A total of 144 patients were included (95 FE and 49 RE). FE were performed under local anaesthetic or sedation, and RE under GA. Success rate of FE and RE were 95.8% and 95.9% respectively. During FE an intra-procedural biopsy was performed in 45/95 (47.3%); with 26/95(27.4%) identifying mucosal pathology. Complications was significantly higher in patients having RE (40.8% versus 6.3%, p = .001). CONCLUSION FE and RE are effective for the therapeutic management of impacted UGIT foreign bodies. However, FE can be performed under LA and was associated with fewer complications, favouring FE where possible as a first line option.
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Ibrahim Y, Browning S. The pressure effects of different commercially available beverages on food boluses in vitro. Eur Arch Otorhinolaryngol 2020; 278:437-443. [PMID: 32930842 DOI: 10.1007/s00405-020-06347-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/29/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Acute oesophageal food impaction is a common and potentially life-threatening condition. Effervescent agents have been used to manage these patients. To date, there have not been any studies comparing the differences in commercially available beverages in relieving food bolus impaction. The aim of this study was to design an in vitro system where the pressure changes generated by different commercially available beverages could be compared in the presence of different food items. METHODS A closed in vitro system was designed using a flask and manometer. Different food items [potato, beef, chicken, and no food item (control)] and different beverages (Coca-Cola®, lemonade, 7 Up Free, Prosecco and water) were inserted into this system in turn. For each food item and beverage, pressure changes (cmH2O) were recorded over a 3-min period. RESULTS Comparing the different food items, the potato appeared to cause the greatest increases in pressure over most time points with all beverages except Coca-Cola® and water. Between the beverages, the lemonade and Prosecco seemed to generate the greatest pressure changes; lemonade generating higher (but non-significant) pressures than the Prosecco with the potato and control. CONCLUSION Our study demonstrates that, in vitro, amongst the beverages, lemonade and Prosecco generated the greatest increases in pressure, whilst potatoes generated a greater reaction than the other food items. These findings need to be studied in further detail and, if deemed clinically relevant, may prompt further investigation for their use in the clinical setting.
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Affiliation(s)
- Yousef Ibrahim
- Department of Otolaryngology, Morriston Hospital, Swansea, SA6 6NL, UK.
| | - Simon Browning
- Department of Otolaryngology, Morriston Hospital, Swansea, SA6 6NL, UK
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Liu H, Wang X, Chen J, der Glas HWV. The Influence of Initial Breakage on Size Reduction during Habitual Chewing of a Solid Test Food. Arch Oral Biol 2020; 118:104852. [PMID: 32758761 DOI: 10.1016/j.archoralbio.2020.104852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/26/2020] [Accepted: 07/17/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Food comminution during chewing is due to intra-oral particle selection and subsequent breakage. Under conditions of habitual chewing and a nearly complete selection, the influence of initial breakage on particle size reduction was studied in trials with a first chewing cycle (N = 1) from a sequence of randomized trials with various cycle numbers. Furthermore, relationships were examined between degree of fragmentation from breakage (r-fr), molar maximal bite force (MBF) and chewing efficiency (the number of cycles needed to half the initial particle size, N(1/2-Xo)). DESIGN Thirty-one subjects with a natural dentition chewed samples of 2 half-cubes (9.6 × 9.6x4.8 mm) of Optosil®, using sequences with 1-7 cycles, in 2-10 randomized trials; 10 trials with one cycle. Particle size distributions by underweight, characterized by median particle size, X50, were obtained using sieving. N(1/2-Xo) was derived from the log(X50)-log(N) relationship. and r-fr from the cumulative distribution of underweight fractions of damaged particles for N = 1. MBF was determined on both sides of the jaw using a force transducer and averaged. CONCLUSIONS A strong, decreasing regression occurred in X50 at N = 1 with r-fr (R2 = 0.934, p < 0.001). The decreasing regression of N(1/2-Xo) with r-fr was moderately strong (R2 = 0.454; p < 0.001). Thus, initial size reduction is strongly determined by breakage and overall reduction partly, when chewing small amounts of particles. N(1/2-Xo) vs. MBF and r-fr vs. MBF were weakly related (R2≤0.124, p = 0.052-0.127). The lack of a pronounced relationship between r-fr and MBF suggests that either MBF is not relevant but supra-threshold force, or that another factor, occlusion, may influence breakage.
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Wahba M, Habib G, Mazny AE, Fawzi M, Elfeki MA, Sabry S, ELbaz M, Nasr SMSE. Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study. Clin Endosc 2019; 52:458-463. [PMID: 31280526 PMCID: PMC6785424 DOI: 10.5946/ce.2019.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/AIMS Food bolus impaction is the most common form of esophageal foreign body impaction observed in adults. Clinical guidelines recommend using the push technique or retrieval methods in such cases. The push technique can cause injuries in certain clinical situations. Notably, conventional retrieval methods are time and effort consuming. Cap-assisted endoscopic extraction of an impacted food bolus is an easy and effective technique; however, more data are needed for its validation. This study compared the capassisted extraction technique with conventional methods. METHODS This prospective observational multicenter study compared the success and en bloc removal rates, total procedure time, and adverse events in both techniques.. RESULTS The study included 303 patients who underwent food bolus extraction. The push technique was used in 87 patients (28.7%) and a retrieval procedure in 216 patients (71.3%). Cap-assisted extraction was performed in 106 patients and retrieval using conventional methods in 110 patients. The cap-assisted technique was associated with a higher rate of en bloc removal (80.2% vs. 15%, p<0.01), shorter procedure time (6.9±3.5 min vs. 15.7±4.1 min, p<0.001), and fewer adverse events (0/106 vs. 9/110, p<0.001). CONCLUSION Cap-assisted extraction showed no adverse events, higher efficacy, and a shorter procedure time compared with conventional retrieval procedures.
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Affiliation(s)
- Mahmoud Wahba
- Division of Gastroenterology, Department of Internal Medicine, Cairo University, Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Ghada Habib
- Cairo University, Kasr Alainy Faculty of Medicine, Tropical Medicine, Cairo, Egypt
| | - Ahmed El Mazny
- Division of Gastroenterology, Department of Internal Medicine, Cairo University, Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - May Fawzi
- Division of Gastroenterology, Department of Internal Medicine, Cairo University, Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Mohamed A Elfeki
- Department of Internal Medicine, Beni-Suef University, Faculty of Medicine, Benisuef, Egypt
| | - Seham Sabry
- Department of Internal Medicine, Al-Azhar University, Faculty of Medicine, Cairo, Egypt
| | - Mahommad ELbaz
- Division of Gastroenterology, Department of Internal Medicine, Cairo University, Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Sayed M Seif El Nasr
- Division of Gastroenterology, Department of Internal Medicine, Cairo University, Kasr Alainy Faculty of Medicine, Cairo, Egypt
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Abstract
OBJECTIVES Food bolus-induced esophageal perforation is much more seldom than iatrogenic and emetic esophageal rupture. We present results from a non-operative treatment approach as well as long-term functional outcome. MATERIALS AND METHODS Medical records of 10 consecutive patients with food bolus-induced esophageal perforation from October 2007 to May 2015 were retrospectively registered in a database. Six patients developed perforation related to endoscopic removal of impacted food, and four during esophageal passage of bone, meat or bread. Treatment was sealing the perforation by stenting (n = 7) with (n = 4) or without (n = 3) chest tube drainage, chest tube drainage (n = 1), observation (n = 1) and gastroesophageal resection (n = 1) because of concomitant emesis of gastric effluent. After median 51 months nine patients reported about dysphagia, fatigue and health-related quality of life. RESULTS Ten patients aged median 62.5 years (range 30-85) stayed in our hospital for 12 days (5-68 days). There was no treatment-related mortality. Nine patients were alive 63 months (18-126) after perforation. Five needed restenting (leakage, migration, impacted stent), two had drainage of a mediastinal abscess, one patient developed a transient esophagobronchial fistula. Dysphagia score was 0 (0-1). One patient developed dysphagia for some solid food. Scores for fatigue and HRQoL was similar to a Norwegian reference population. CONCLUSION Treatment mainly with a non-operative approach occurred without mortality. Complications were handled by restenting and abscess drainage. Functional result for dysphagia was excellent. Interesting results on fatigue and HRQoL must be interpreted with caution because of a limited patient material.
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Affiliation(s)
- Tobias Hauge
- a Department of Surgery , Drammen Hospital, Vestre Viken HF , Drammen , Norway
| | - Ole Christian Kleven
- b Department of Surgery , Lillehammer Hospital, Sykehuset Innlandet , Lillehammer , Norway
| | - Egil Johnson
- c Department of Pediatric and Gastrointestinal Surgery , Oslo University Hospital , Oslo , Norway.,d Institute of Clinical Medicine , University of Oslo , Oslo , Norway
| | - Bjørn Hofstad
- e Department of Gastroenterology , Oslo University Hospital , Oslo , Norway
| | - Hans-Olaf Johannessen
- c Department of Pediatric and Gastrointestinal Surgery , Oslo University Hospital , Oslo , Norway
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Mathieu V, de Loubens C, Thomas C, Panouillé M, Magnin A, Souchon I. An experimental model to investigate the biomechanical determinants of pharyngeal mucosa coating during swallowing. J Biomech 2018; 72:144-151. [PMID: 29559243 DOI: 10.1016/j.jbiomech.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/23/2018] [Accepted: 03/03/2018] [Indexed: 11/30/2022]
Abstract
The development of innovative experimental approaches is necessary to gain insights in the complex biomechanics of swallowing. In particular, unraveling the mechanisms of formation of the thin film of bolus coating the pharyngeal mucosa after the ingestion of liquid or semi-liquid food products is an important challenge, with implication in dysphagia treatment and sensory perceptions. The aim here is to propose an original experimental model of swallowing (i) to simulate the peristaltic motions driving the bolus from the oral cavity to the esophagus, (ii) to mimic and vary complex physiological variables of the pharyngeal mucosa (lubrication, deformability and velocity) and (iii) to measure the thickness and the composition of the coatings resulting from bolus flow. Three Newtonian glucose solutions were considered as model food boli, through sets of experiments covering different ranges of each physiological parameter mimicked. The properties of the coatings (thickness and dilution in saliva film) were shown to depend significantly on the physical properties of food products considered (viscosity and density), but also on physiological variables such as lubrication by saliva, velocity of the peristaltic wave, and to a lesser extent, the deformability of the pharyngeal mucosa. The biomechanical peristalsis simulator developed here can contribute to unravel the determinants of bolus adhesion on pharyngeal mucosa, necessary both for the design of alternative food products for people affected by swallowing disorders, and for a better understanding of the dynamic mechanisms of aroma perception.
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Affiliation(s)
- Vincent Mathieu
- UMR GMPA, INRA, AgroParisTech, Université Paris-Saclay, 78850 Thiverval-Grignon, France.
| | - Clément de Loubens
- UMR GMPA, INRA, AgroParisTech, Université Paris-Saclay, 78850 Thiverval-Grignon, France; Univ. Grenoble Alpes, CNRS, Grenoble INP (Institute of Engineering Univ. Grenoble Alpes), LRP, 38000 Grenoble, France
| | - Chloé Thomas
- UMR GMPA, INRA, AgroParisTech, Université Paris-Saclay, 78850 Thiverval-Grignon, France
| | - Maud Panouillé
- UMR GMPA, INRA, AgroParisTech, Université Paris-Saclay, 78850 Thiverval-Grignon, France
| | - Albert Magnin
- Univ. Grenoble Alpes, CNRS, Grenoble INP (Institute of Engineering Univ. Grenoble Alpes), LRP, 38000 Grenoble, France
| | - Isabelle Souchon
- UMR GMPA, INRA, AgroParisTech, Université Paris-Saclay, 78850 Thiverval-Grignon, France
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11
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Assad-Bustillos M, Tournier C, Septier C, Della Valle G, Feron G. Relationships of oral comfort perception and bolus properties in the elderly with salivary flow rate and oral health status for two soft cereal foods. Food Res Int 2017; 118:13-21. [PMID: 30898347 DOI: 10.1016/j.foodres.2017.11.057] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/19/2017] [Accepted: 11/22/2017] [Indexed: 02/07/2023]
Abstract
The aim of this study was to investigate food oral processing and bolus formation in the elderly population, and their relationship with the perception of oral comfort, for two soft cereal products of different composition: sponge-cake and brioche. Twenty subjects aged 65 and over participated in the study. They were classified in two groups according to dental status (poor vs. satisfactory) and presented various stimulated salivary flow rate (SSF) in each group. Food bolus properties (hydration ratio and apparent viscosity) were characterized after three chewing stages for both groups. Results showed that chewing duration did not depend on food product but rather on physiology: subjects with a poor dental status had a shorter chewing duration. For each chewing stage, sponge-cake boli showed a higher hydration ratio than brioche boli, which showed higher apparent viscosity. For sponge-cake, perception of oral comfort was primarily driven by SSF rate, irrespective of the dental status. In the case of brioche, oral comfort was also partially explained by SSF in the case of subjects with poor dental status. This result suggests that perception of oral comfort in brioche could be driven by product related attributes rather than oral health. For both foods, a phenomenological model of bolus viscosity as a function of stimulated salivary flow and chewing duration was proposed.
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Affiliation(s)
- M Assad-Bustillos
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, F-21000 Dijon, France; INRA UR-1268 Biopolymères Interactions et Assemblages, La Géraudière, 44316 Nantes, France; CERELAB®, La Sucrerie, 21110 Aiserey, France
| | - C Tournier
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - C Septier
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - G Della Valle
- INRA UR-1268 Biopolymères Interactions et Assemblages, La Géraudière, 44316 Nantes, France
| | - G Feron
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, F-21000 Dijon, France.
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12
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Wada S, Kawate N, Mizuma M. What Type of Food Can Older Adults Masticate?: Evaluation of Mastication Performance Using Color-Changeable Chewing Gum. Dysphagia 2017; 32:636-43. [PMID: 28474132 DOI: 10.1007/s00455-017-9807-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/22/2017] [Indexed: 11/17/2022]
Abstract
This study determines if older adults can masticate regular foods via a simple test conducted using a color-changeable chewing gum. Seventy-nine consecutive inpatients of our clinic receiving rehabilitation and general medicine were assessed for eligibility. The inclusion criterion was >65 years. Thirty patients consented to participate. The main outcome variable was the food bolus texture at the swallowing threshold for five regular foods. The main explanatory variable was the a* value of the color-changeable chewing gum after 120 s of chewing (a* represents the degree of color between red and green, and a positive a* value indicates red). The mean age ± standard deviation of the participants was 81.6 ± 8.6 years, and 40% were men. Participants being able to prepare the food with suitable texture for swallowing was positively associated with the a* values in boiled rice, ginger-fried pork loin, boiled fish-paste, and rice cracker (Crude OR 1.18, 1.15, 1.17, and 1.50; P < 0.001, = 0.026, <0.001, and <0.001, respectively). The cut-off a* values had markedly high specificities (1.0) for boiled rice and boiled fish-paste and high sensitivities (0.86–0.94) for three foods, except boiled rice. We believe that mastication evaluation using the color-changeable chewing gum is not only useful but also extremely practical, even for older adults in a wide range of settings, including an individual’s home. This approach would lead to a reduction in unnecessary mechanically altered or pureed food for older adults who can eat pureed food and safely provide palatable food.
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