Differentiation of normal and abnormal airway protection during swallowingusing the penetration-aspiration scale

Accidental loss of food or liquids into the airway while eating or drinking is perhaps the most clinically significant consequence of dysphagia. Altho ugh videofluoroscopic recording of swallowing is the current gold standard for identifying and determining remediation for aspiration, results are gen erally described in descriptive terms, thus limiting information and lendin g to errors of interpretation. We previously published an 8-point scale to quantitate selected aspects of penetration and aspiration conveying depth o f airway invasion and whether or not material entering the airway is expell ed (Rosenbek et al., 1996, Dysphagia 11:93-98). The present study defines t he distribution of the Penetration-Aspiration Scale scores in healthy norma l subjects of different genders and ages. The scale was also used with two groups of patients known to have significant dysphagia relative to stroke o r head and neck cancer. Significant differences found among groups are disc ussed.