Differences of Aspiration between Liquid and Solid Foods in Video Fluoroscopic Swallowing Study: A Review of Literature

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The videofluoroscopic swallowing study (VFSS) is commonly considered the gold standard for assessing a patient’s swallowing ability. Most dysphagic patients arrange food to make it thicker or softer and thus easier and safer to swallow. A popular point of discussion, even argument, about VFSS among clinicians is whether to use barium sulfate in isolation or in combination with real food. No firm answer has emerged from these discussions, and proponents of both perspectives have seemingly valid points. The aim of the present study was to review whether there were differences between the results using liquid or solid foods in VFSS. We performed a literature search and interpreted the data acquired according to a systematic method. After data extraction and interpretation, we were left with 14 publications that were considered relevant. Most of the research showed that the rate of aspiration was higher with liquids than with solid foods. According to the results of VFSS by using the various textured-foods, the aspiration risk was highest with two-phase food diet such as the mixtures of liquid and solid foods. However, descriptions of their results were often inadequate although many test foods were used for the VFSS. There were a few publications containing the detailed information of the food textures. As the VFSS images provide valuable data, the methods and the results should be described in as much detail as possible to help readers of the articles. Most patients make allowances for the differences in thin liquids, thick liquids, and solid foods. Hence, writing the details of test food textures would lead to improve the quality of the VFSS in the future.