Farklı Orofaringeal Açıklık Derecelerine Sahip Sağlıklı Bireylerde Katı Yutma Parametrelerinin Karşılaştırılması
Yıl 2026,
Cilt: 11 Sayı: 1, 40 - 46, 15.03.2026
Cetin Sayaca
,
Esra Ulu
,
Özden Özkal
Öz
Amaç: Orofarebgeal açıklığı dar olan bireyler katı besinleri yutmada zorluk yaşayabilirler. Bu çalışmada amaç, orofarengeal açıklık derecesi ile katı besin yutma performans parametreleri arasındaki ilişkiyi incelemektir. Materyal ve Metot: Bireylerin orofarengeal açıklık derecesi “Mallampati Sınıflaması” ile değerlendirildi. Bireyler, bu sınıflandırmaya göre dört gruba ayrıldı. Katı besin yutma performansı “Katıları Çiğneme ve Yutma Testi” kullanılarak değerlendirildi. Bireylerin krakeri yedikleri esnada ısırma, çiğneme ve yutkunma sayıları ile toplam yeme süreleri kaydedildi. Bulgular: Çalışmaya 18-65 yaş aralığında, yutma güçlüğü şikâyeti olmayan toplam 176 birey (96 kadın, 80 erkek) dahil edildi. Katı besin yutma performans parametreleri arasında ısırma sayısı açısından sınıflar arasında fark vardı (p = 0.047). Sınıf I ile III ve Sınıf II ile III arasında fark vardı (p = 0.018; p = 0.026, sırasıyla). Çiğneme sayısı, yutkunma sayısı ve toplam yeme süresi açısından sınıflar arasında fark yoktu (p = 0.108; p = 0.768; p = 0.256, sırasıyla). Sonuç: Orofarengeal açıklık derecesi katı besin yutma parametreleri etkilememektedir. Yutma bozukluğu olmayan bireylerde katı besin yeme sürelerini orofarengeal açıklıktan daha çok yeme alışkanlıklarının etkilediği düşünülmektedir.
Etik Beyan
Çalışmanın kapsamı ve yöntemleri hakkında bilgilendirildikten sonra, bireyler bilgilendirilmiş onam formlarını imzaladılar. Bu çalışma, Helsinki Bildirgesi'nin etik kuralları ve ilkelerine uygun olarak yürütülmüştür. Bursa Uludağ Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu çalışmayı onaylamıştır (Tarih: 16.07.2025, Karar No: 2025/13/8).
Destekleyen Kurum
Yazarların hiçbiri, bu çalışmada toplanan veriler ve kullanılan prosedürlerle ilgili olarak herhangi bir çıkar çatışması taşımamaktadır. Yazarlar, çalışma tasarımında, verilerin toplanması, analizi ve yorumlanmasında, makalenin yazımında ve makalenin yayına sunulması kararında herhangi bir sponsorlarının olmadığını beyan ederler.
Teşekkür
Yazarlar, çalışmaya katılmayı kabul eden tüm bireylere ve yazım dilini kontrol eden Arzu TAŞOCAK'a teşekkürlerini sunarlar.
Kaynakça
-
1. Logemann JA. Dysphagia: Evaluation and treatment. Folia Phoniatrica et Logopaedica. 1995;47(3):140–164. doi:10.1159/000266348
-
1. Logemann JA. Dysphagia: Evaluation and treatment. Folia Phoniatrica et Logopaedica. 1995;47(3):140–164. doi:10.1159/000266348
-
2. Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiological Reviews. 2001;81(2):929–969. doi: 10.1152/physrev.2001.81.2.929
-
2. Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiological Reviews. 2001;81(2):929–969. doi: 10.1152/physrev.2001.81.2.929
-
3. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clinical Neurophysiology. 2003;114(12):2226–2244. doi:10.1016/s1388-2457(03)00237-2
-
3. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clinical Neurophysiology. 2003;114(12):2226–2244. doi:10.1016/s1388-2457(03)00237-2
-
4. Dodds WJ. Radiologicassessment of abnormal oral and pharyngeal phases of swal-lowing. AJR. American Journal of Roentgenology, 1990;154:965–974. doi:10.2214/ajr.154.5.2108570
-
4. Dodds WJ. Radiologicassessment of abnormal oral and pharyngeal phases of swal-lowing. AJR. American Journal of Roentgenology, 1990;154:965–974. doi:10.2214/ajr.154.5.2108570
-
5. Matsuo K, Palmer, JB. Anatomy and physiology of feedingand swallowing: Normal and abnormal. Physical Medicine and Rehabilitation Clinics of North America. 2008;19, 691–707. doi:10.1016/j.pmr.2008.06.001
-
5. Matsuo K, Palmer, JB. Anatomy and physiology of feedingand swallowing: Normal and abnormal. Physical Medicine and Rehabilitation Clinics of North America. 2008;19, 691–707. doi:10.1016/j.pmr.2008.06.001
-
6. Matsuo K, Palmer, JB. Video fluoroscopic techniquesfor the study of Oral food processing. Current Opinion in FoodScience. 2016;9, 1–10. doi:10.1016/j.cofs.2016.03.004
-
6. Matsuo K, Palmer, JB. Video fluoroscopic techniquesfor the study of Oral food processing. Current Opinion in FoodScience. 2016;9, 1–10. doi:10.1016/j.cofs.2016.03.004
-
7. Rosero Salazar DH, Honnlee L, Nguyen PH, Willis E, Liu ZJ. Spatial relationships of oropharyngeal structures during respiration, chewing, and swallowing. The Anatomical Record. 2024 Dec 2. doi:10.1002/ar.25605
-
7. Rosero Salazar DH, Honnlee L, Nguyen PH, Willis E, Liu ZJ. Spatial relationships of oropharyngeal structures during respiration, chewing, and swallowing. The Anatomical Record. 2024 Dec 2. doi:10.1002/ar.25605
-
8. Finkelstein Y, Lerner MA, Ophir D, Nachmani A, Hauben DJ, Zohar Y. Nasopharyngeal profile and velopharyngeal valve mechanism. Plastic and Reconstructive Surgery. 1993;92(4):603–614. doi:10.1097/00006534-199309001-00008
-
8. Finkelstein Y, Lerner MA, Ophir D, Nachmani A, Hauben DJ, Zohar Y. Nasopharyngeal profile and velopharyngeal valve mechanism. Plastic and Reconstructive Surgery. 1993;92(4):603–614. doi:10.1097/00006534-199309001-00008
-
9. Radhakrishnan C, Sefidani Forough A, Cichero JAY, et al. A difficult pill to swallow: An investigation of the factors associated with medication swallowing difficulties. Patient Preference and Adherence. 2021;15:29–40. doi:10.2147/PPA.S277238
-
9. Radhakrishnan C, Sefidani Forough A, Cichero JAY, et al. A difficult pill to swallow: An investigation of the factors associated with medication swallowing difficulties. Patient Preference and Adherence. 2021;15:29–40. doi:10.2147/PPA.S277238
-
10. Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: A prospective study. Canadian Anaesthetists’ Society Journal. 1985;32(4):429–434. doi:10.1007/BF03011357
-
10. Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: A prospective study. Canadian Anaesthetists’ Society Journal. 1985;32(4):429–434. doi:10.1007/BF03011357
-
11. Lesavoy B, Lumsden C, Grunstein E, Yoon R. Mallampati and Brodsky classification and children's risk for sleep related breathing disorder. Journal of Clinical Pediatric Dentistry. 2022;46(4):280–286. doi:10.22514/1053-4625-46.4.4
-
11. Lesavoy B, Lumsden C, Grunstein E, Yoon R. Mallampati and Brodsky classification and children's risk for sleep related breathing disorder. Journal of Clinical Pediatric Dentistry. 2022;46(4):280–286. doi:10.22514/1053-4625-46.4.4
-
12. Liu J, Fukuda H, Kondo E, Sakai Y, Sakai H, Kurita H. Screening of aspiration pneumonia using the modified Mallampati classification tool in older adults. PLOS ONE. 2024;19(5):e0302384. doi:10.1371/journal.pone.0302384
-
12. Liu J, Fukuda H, Kondo E, Sakai Y, Sakai H, Kurita H. Screening of aspiration pneumonia using the modified Mallampati classification tool in older adults. PLOS ONE. 2024;19(5):e0302384. doi:10.1371/journal.pone.0302384
-
13. Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing: a review. Dysphagia. 2010;25(4):323-333. doi:10.1007/s00455-010-9301-5
-
13. Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing: a review. Dysphagia. 2010;25(4):323-333. doi:10.1007/s00455-010-9301-5
-
14. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas PJ. Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. J Speech Lang Hear Res. 2002;45(3):434-445. doi:10.1044/1092-4388(2002/034)
-
14. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas PJ. Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. J Speech Lang Hear Res. 2002;45(3):434-445. doi:10.1044/1092-4388(2002/034)
-
15. Palmer JB, Rudin NJ, Lara G, Crompton AW. Coordination of mastication and swallowing. Dysphagia. 1992;7(4):187-200. doi:10.1007/BF02493469
-
15. Palmer JB, Rudin NJ, Lara G, Crompton AW. Coordination of mastication and swallowing. Dysphagia. 1992;7(4):187-200. doi:10.1007/BF02493469
-
16. Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42(5):487–490. doi:10.1111/j.1365-2044.1987.tb04039.x
-
16. Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42(5):487–490. doi:10.1111/j.1365-2044.1987.tb04039.x
-
17. Jackson JS, Rondeau B. Mallampati Score. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK585119/. Accessed December 8, 2025.
-
17. Jackson JS, Rondeau B. Mallampati Score. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK585119/. Accessed December 8, 2025.
-
18. Huckabee ML, McIntosh T, Fuller L, et al. The Test of Masticating and Swallowing Solids (TOMASS): Reliability, validity and international normative data. International Journal of Language & Communication Disorders. 2018;53(1):144–156. doi:10.1111/1460-6984.12332
-
18. Huckabee ML, McIntosh T, Fuller L, et al. The Test of Masticating and Swallowing Solids (TOMASS): Reliability, validity and international normative data. International Journal of Language & Communication Disorders. 2018;53(1):144–156. doi:10.1111/1460-6984.12332
-
19. Kavakcı M, Ozdemir S, Aras B, Kuruoğlu E. Turkish normative data for the Test of Masticating and Swallowing Solids (TOMASS). Çukurova Medical Journal. 2021;46(3):920–926.
-
19. Kavakcı M, Ozdemir S, Aras B, Kuruoğlu E. Turkish normative data for the Test of Masticating and Swallowing Solids (TOMASS). Çukurova Medical Journal. 2021;46(3):920–926.
-
20. Todaro F, Pizzorni N, Scarponi L, Ronzoni C, Huckabee ML, Schindler A. The Test of Masticating and Swallowing Solids (TOMASS): Reliability and validity in patients with dysphagia. International Journal of Language & Communication Disorders. 2021;56(3):558–566. doi:10.1111/1460-6984.12613
-
20. Todaro F, Pizzorni N, Scarponi L, Ronzoni C, Huckabee ML, Schindler A. The Test of Masticating and Swallowing Solids (TOMASS): Reliability and validity in patients with dysphagia. International Journal of Language & Communication Disorders. 2021;56(3):558–566. doi:10.1111/1460-6984.12613
-
21. Omari T, Ross A, Schar M, et al. Effect of thickened fluids on swallowing function in oropharyngeal dysphagia: Impact of shear rheology and disorder subtype. Neurogastroenterology & Motility. 2025;37(4):e15003. doi:10.1111/nmo.15003
-
21. Omari T, Ross A, Schar M, et al. Effect of thickened fluids on swallowing function in oropharyngeal dysphagia: Impact of shear rheology and disorder subtype. Neurogastroenterology & Motility. 2025;37(4):e15003. doi:10.1111/nmo.15003
-
22. Peyron MA, Lassauzay C, Woda A. Effects of increased hardness on jaw movement and muscle activity during chewing of viscoelastic model foods. Experimental Brain Research. 2004;154(1):41-51.
-
22. Peyron MA, Lassauzay C, Woda A. Effects of increased hardness on jaw movement and muscle activity during chewing of viscoelastic model foods. Experimental Brain Research. 2004;154(1):41-51.
Comparison of Solid Swallowing Parameters in Healthy Individuals with Different Oropharyngeal Aperture Degrees
Yıl 2026,
Cilt: 11 Sayı: 1, 40 - 46, 15.03.2026
Cetin Sayaca
,
Esra Ulu
,
Özden Özkal
Öz
Objective: Individuals with a narrow oropharyngeal aperture may experience difficulty swallowing solid food. The purpose of the present study was to investigate the relationship between the oropharyngeal aperture degrees and solid food swallowing performance parameters. Materials and Methods: The oropharyngeal aperture degree of the individuals was evaluated using the Mallampati classification. Based on this classification, the individuals were divided into four classes. Solid-food swallowing performance was evaluated using the Test of Masticating and Swallowing Solids. The number of bites, chews, and swallows, and the total eating time were recorded while individuals were eating the cracker. Result: A total of 176 individuals (96 females, 80 males) aged 18-65 years and without a complaint of swallowing difficulties, were included in the study. A difference was found among the classes in the number of bites during solid-food swallowing performance (p = 0.047). There was a difference between Class-I and Class-III (p = 0.018) and between Class-II and Class-III (p = 0.026). No difference was found among the classes regarding the number of chewing cycles, the number of swallows, and the total eating time (p = 0.108; p = 0.768; p = 0.256, respectively). Conclusion: The oropharyngeal aperture degrees do not affect solid food swallowing parameters. It is generally accepted that eating habits, rather than the oropharyngeal opening, influence the time required to eat solid foods in individuals without dysphagia.
Etik Beyan
After the individuals were informed of the scope and procedures of the present study, they signed informed consent forms. The present study was conducted in accordance with the ethical guidelines and principles of the Declaration of Helsinki. The Bursa Uludag University Noninvasive Clinical Research Ethics Committee approved the study (Date:16.07.2025, Decision No:2025/13/8).
Destekleyen Kurum
All authors have no conflicts of interest with respect to the data collected and procedures used within this study. Authors declare that they have no sponsor in the study design, in the collection, analysis and interpretation of data, in writing of the manuscript, and in the decision to submit the manuscript for publication.
Teşekkür
The authors wish to acknowledge all patients who accepted to join, and Arzu TAŞOCAK who check spelling language.
Kaynakça
-
1. Logemann JA. Dysphagia: Evaluation and treatment. Folia Phoniatrica et Logopaedica. 1995;47(3):140–164. doi:10.1159/000266348
-
1. Logemann JA. Dysphagia: Evaluation and treatment. Folia Phoniatrica et Logopaedica. 1995;47(3):140–164. doi:10.1159/000266348
-
2. Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiological Reviews. 2001;81(2):929–969. doi: 10.1152/physrev.2001.81.2.929
-
2. Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiological Reviews. 2001;81(2):929–969. doi: 10.1152/physrev.2001.81.2.929
-
3. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clinical Neurophysiology. 2003;114(12):2226–2244. doi:10.1016/s1388-2457(03)00237-2
-
3. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clinical Neurophysiology. 2003;114(12):2226–2244. doi:10.1016/s1388-2457(03)00237-2
-
4. Dodds WJ. Radiologicassessment of abnormal oral and pharyngeal phases of swal-lowing. AJR. American Journal of Roentgenology, 1990;154:965–974. doi:10.2214/ajr.154.5.2108570
-
4. Dodds WJ. Radiologicassessment of abnormal oral and pharyngeal phases of swal-lowing. AJR. American Journal of Roentgenology, 1990;154:965–974. doi:10.2214/ajr.154.5.2108570
-
5. Matsuo K, Palmer, JB. Anatomy and physiology of feedingand swallowing: Normal and abnormal. Physical Medicine and Rehabilitation Clinics of North America. 2008;19, 691–707. doi:10.1016/j.pmr.2008.06.001
-
5. Matsuo K, Palmer, JB. Anatomy and physiology of feedingand swallowing: Normal and abnormal. Physical Medicine and Rehabilitation Clinics of North America. 2008;19, 691–707. doi:10.1016/j.pmr.2008.06.001
-
6. Matsuo K, Palmer, JB. Video fluoroscopic techniquesfor the study of Oral food processing. Current Opinion in FoodScience. 2016;9, 1–10. doi:10.1016/j.cofs.2016.03.004
-
6. Matsuo K, Palmer, JB. Video fluoroscopic techniquesfor the study of Oral food processing. Current Opinion in FoodScience. 2016;9, 1–10. doi:10.1016/j.cofs.2016.03.004
-
7. Rosero Salazar DH, Honnlee L, Nguyen PH, Willis E, Liu ZJ. Spatial relationships of oropharyngeal structures during respiration, chewing, and swallowing. The Anatomical Record. 2024 Dec 2. doi:10.1002/ar.25605
-
7. Rosero Salazar DH, Honnlee L, Nguyen PH, Willis E, Liu ZJ. Spatial relationships of oropharyngeal structures during respiration, chewing, and swallowing. The Anatomical Record. 2024 Dec 2. doi:10.1002/ar.25605
-
8. Finkelstein Y, Lerner MA, Ophir D, Nachmani A, Hauben DJ, Zohar Y. Nasopharyngeal profile and velopharyngeal valve mechanism. Plastic and Reconstructive Surgery. 1993;92(4):603–614. doi:10.1097/00006534-199309001-00008
-
8. Finkelstein Y, Lerner MA, Ophir D, Nachmani A, Hauben DJ, Zohar Y. Nasopharyngeal profile and velopharyngeal valve mechanism. Plastic and Reconstructive Surgery. 1993;92(4):603–614. doi:10.1097/00006534-199309001-00008
-
9. Radhakrishnan C, Sefidani Forough A, Cichero JAY, et al. A difficult pill to swallow: An investigation of the factors associated with medication swallowing difficulties. Patient Preference and Adherence. 2021;15:29–40. doi:10.2147/PPA.S277238
-
9. Radhakrishnan C, Sefidani Forough A, Cichero JAY, et al. A difficult pill to swallow: An investigation of the factors associated with medication swallowing difficulties. Patient Preference and Adherence. 2021;15:29–40. doi:10.2147/PPA.S277238
-
10. Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: A prospective study. Canadian Anaesthetists’ Society Journal. 1985;32(4):429–434. doi:10.1007/BF03011357
-
10. Mallampati SR, Gatt SP, Gugino LD, et al. A clinical sign to predict difficult tracheal intubation: A prospective study. Canadian Anaesthetists’ Society Journal. 1985;32(4):429–434. doi:10.1007/BF03011357
-
11. Lesavoy B, Lumsden C, Grunstein E, Yoon R. Mallampati and Brodsky classification and children's risk for sleep related breathing disorder. Journal of Clinical Pediatric Dentistry. 2022;46(4):280–286. doi:10.22514/1053-4625-46.4.4
-
11. Lesavoy B, Lumsden C, Grunstein E, Yoon R. Mallampati and Brodsky classification and children's risk for sleep related breathing disorder. Journal of Clinical Pediatric Dentistry. 2022;46(4):280–286. doi:10.22514/1053-4625-46.4.4
-
12. Liu J, Fukuda H, Kondo E, Sakai Y, Sakai H, Kurita H. Screening of aspiration pneumonia using the modified Mallampati classification tool in older adults. PLOS ONE. 2024;19(5):e0302384. doi:10.1371/journal.pone.0302384
-
12. Liu J, Fukuda H, Kondo E, Sakai Y, Sakai H, Kurita H. Screening of aspiration pneumonia using the modified Mallampati classification tool in older adults. PLOS ONE. 2024;19(5):e0302384. doi:10.1371/journal.pone.0302384
-
13. Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing: a review. Dysphagia. 2010;25(4):323-333. doi:10.1007/s00455-010-9301-5
-
13. Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing: a review. Dysphagia. 2010;25(4):323-333. doi:10.1007/s00455-010-9301-5
-
14. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas PJ. Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. J Speech Lang Hear Res. 2002;45(3):434-445. doi:10.1044/1092-4388(2002/034)
-
14. Logemann JA, Pauloski BR, Rademaker AW, Kahrilas PJ. Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. J Speech Lang Hear Res. 2002;45(3):434-445. doi:10.1044/1092-4388(2002/034)
-
15. Palmer JB, Rudin NJ, Lara G, Crompton AW. Coordination of mastication and swallowing. Dysphagia. 1992;7(4):187-200. doi:10.1007/BF02493469
-
15. Palmer JB, Rudin NJ, Lara G, Crompton AW. Coordination of mastication and swallowing. Dysphagia. 1992;7(4):187-200. doi:10.1007/BF02493469
-
16. Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42(5):487–490. doi:10.1111/j.1365-2044.1987.tb04039.x
-
16. Samsoon GL, Young JR. Difficult tracheal intubation: A retrospective study. Anaesthesia. 1987;42(5):487–490. doi:10.1111/j.1365-2044.1987.tb04039.x
-
17. Jackson JS, Rondeau B. Mallampati Score. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK585119/. Accessed December 8, 2025.
-
17. Jackson JS, Rondeau B. Mallampati Score. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK585119/. Accessed December 8, 2025.
-
18. Huckabee ML, McIntosh T, Fuller L, et al. The Test of Masticating and Swallowing Solids (TOMASS): Reliability, validity and international normative data. International Journal of Language & Communication Disorders. 2018;53(1):144–156. doi:10.1111/1460-6984.12332
-
18. Huckabee ML, McIntosh T, Fuller L, et al. The Test of Masticating and Swallowing Solids (TOMASS): Reliability, validity and international normative data. International Journal of Language & Communication Disorders. 2018;53(1):144–156. doi:10.1111/1460-6984.12332
-
19. Kavakcı M, Ozdemir S, Aras B, Kuruoğlu E. Turkish normative data for the Test of Masticating and Swallowing Solids (TOMASS). Çukurova Medical Journal. 2021;46(3):920–926.
-
19. Kavakcı M, Ozdemir S, Aras B, Kuruoğlu E. Turkish normative data for the Test of Masticating and Swallowing Solids (TOMASS). Çukurova Medical Journal. 2021;46(3):920–926.
-
20. Todaro F, Pizzorni N, Scarponi L, Ronzoni C, Huckabee ML, Schindler A. The Test of Masticating and Swallowing Solids (TOMASS): Reliability and validity in patients with dysphagia. International Journal of Language & Communication Disorders. 2021;56(3):558–566. doi:10.1111/1460-6984.12613
-
20. Todaro F, Pizzorni N, Scarponi L, Ronzoni C, Huckabee ML, Schindler A. The Test of Masticating and Swallowing Solids (TOMASS): Reliability and validity in patients with dysphagia. International Journal of Language & Communication Disorders. 2021;56(3):558–566. doi:10.1111/1460-6984.12613
-
21. Omari T, Ross A, Schar M, et al. Effect of thickened fluids on swallowing function in oropharyngeal dysphagia: Impact of shear rheology and disorder subtype. Neurogastroenterology & Motility. 2025;37(4):e15003. doi:10.1111/nmo.15003
-
21. Omari T, Ross A, Schar M, et al. Effect of thickened fluids on swallowing function in oropharyngeal dysphagia: Impact of shear rheology and disorder subtype. Neurogastroenterology & Motility. 2025;37(4):e15003. doi:10.1111/nmo.15003
-
22. Peyron MA, Lassauzay C, Woda A. Effects of increased hardness on jaw movement and muscle activity during chewing of viscoelastic model foods. Experimental Brain Research. 2004;154(1):41-51.
-
22. Peyron MA, Lassauzay C, Woda A. Effects of increased hardness on jaw movement and muscle activity during chewing of viscoelastic model foods. Experimental Brain Research. 2004;154(1):41-51.