[The role of saliva swallowing in the bedside assessment of dysphagia - a state-of-the-art review]

Abstract

Our saliva production is continuous, and we regularly swallow the saliva that accumulates in the oral cavity. The patient’s ability to manage secretions therefore seems to be an obvious variable in the assessment of a swallowing disorder. Nevertheless, even in validated bedside surveys, it appears in different forms and with different emphasis. In our literature review, we investigated this phenomenon, known in the literature as saliva swallowing or dry swallowing, using a state-of-the-art literature review methodology. We sought to answer the questions of how the physiology of dry swallowing can be described and whether it has neuroanatomical features that distinguish it from nutritional swallowing. Furthermore, what validated dry swallowing tests are available for dysphagia screening that can be safely used in national practice? Are there specific protocols for dry swallow testing? Is there a relevant standard practice? As a result of our thesis, we have formulated principles that can be generalized to several patient groups, it can be of direct practical use to professionals managing adult patient populations with dysphagia and it may offer new areas of research. Spontaneous swallowing frequency should be taken into account during patient assessment. In the absence of a spontaneous swallowing event, stimulation should be attempted to induce salivation, followed only by a dry swallow test on demand. Only after observation of salivation should a swallow test be performed with different consistencies. It is always recommended that dry swallowing results should be interpreted in the context of other variables indicative of dysphagia. Orv Hetil. 2024; 165(12): 443–454.

Keywords: betegágy melletti vizsgálat; clinical bedside assessment; dysphagia; nyelészavar; state-of-the-art review; ’state-of-the-art review’.