![]() ![]() One survey of Canadian clinicians practicing in dysphagia indicated that it was not common to use standardized protocols for preparing in-house stimuli. For institutions without access to these products, clinicians have no alternative but to prepare their own VFSS stimuli by mixing barium sulfate liquid or powder with regular liquids and solids to achieve radiopacity. Some commercially available products (e.g., Varibar ®) containing a controlled concentration of barium sulfate are offered in a range of consistencies (e.g., thin, nectar-thick, honey-thick) however, these are not universally used nor are they even available in some regions outside the United States. In North America, barium sulfate is widely used as this radiopaque element. In order to view a bolus under fluoroscopy, all food and stimuli must contain a radiopaque element. Videofluoroscopic swallow studies (VFSS) are a commonly used instrumental method for evaluating oropharyngeal safety for and efficiency of individuals with suspected dysphagia (swallowing impairment). Clinicians need to understand and control for the impact of different barium stimuli on swallowing physiology. Barium concentration influences timing parameters in healthy swallowing, even between ultrathin and thin concentrations. In all cases, longer durations were seen with the higher barium concentration. Significant differences were observed in the timing measures of swallowing with respect to barium concentration. The measures of interest were stage transition duration, pharyngeal transit time, and duration of upper esophageal sphincter opening. Timing measures were compared between barium concentrations using a mixed-model ANOVA. Twenty healthy adults (Ten women mean age = 31 years) each performed a series of three noncued 5-ml swallows each of ultrathin and thin liquid barium solutions in videofluoroscopy. The aim of our study was to identify timing differences in healthy swallowing between “thin” (40 % w/v concentration) and “ultrathin” (22 % w/v concentration) barium solutions. Prior studies suggest that some aspects of swallowing, including timing measures of oral and pharyngeal bolus transit, vary depending on barium concentration. Videofluoroscopy is commonly used for evaluating oropharyngeal swallowing but requires radiopaque contrast (typically barium). ![]()
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