Development of evaluation method of salivary aspiration using videoendoscope

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K11444
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Social dentistry
• Research Institution: Osaka University
• Principal Investigator: Nohara Kanji 大阪大学, 歯学研究科, 准教授 (20346167)
• Co-Investigator(Kenkyū-buntansha): 高井 英月子 大阪大学, 歯学部附属病院, 医員 (30532642) ; 深津 ひかり 大阪大学, 歯学部附属病院, 医員 (00635386)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 誤嚥 / 唾液誤嚥 / 嚥下内視鏡 / 誤嚥性肺炎

Outline of Final Research Achievements

In this study, we developed a method to evaluate salivary aspiration noninvasively using video-endoscope, and compare the results of the developed evaluation method of salivary aspiration with the previous evaluation methods. Another purpose of this study was to examine the relationship between the evaluation results of salivary aspiration developed in this study and the onset of pneumonia.
The subjects were 122 dysphagic patients, and the results of comparing the PAS score of saliva aspiration evaluated by the previous method and the developed in this study were as follows. It was found that the PAS score showed higher values when saliva was dyed compared to when it was not dyed, and that minor aspirations could also be detected when dyed. Although the dyed salivary PAS score in the pneumonia group was larger than that in the non-pneumonia group, no significant difference was observed.

Free Research Field

摂食嚥下障害

Academic Significance and Societal Importance of the Research Achievements

これまで誤嚥に関しては食物の誤嚥に注目され，食物誤嚥の検査方法や食物誤嚥と肺炎発症の関係などが研究されてきた．しかしながら，呼吸器内科の観点からは，食物誤嚥によって生じる化学的な肺炎ではなく，細菌を含んだ唾液を誤嚥することによって生じる細菌性の誤嚥性肺炎が重要とされる．本研究の結果，唾液誤嚥が詳細に評価できることとなった．今回の研究で確立できた唾液誤嚥の評価法は，唾液と肺炎の間のミッシングリンクを繋ぐものであり国際的にも新規性が高く，今後研究や臨床で広く応用される可能性を有している．今回は肺炎発症との関連が有意でなかったものの，症例や他の因子を増やして検討する意義は十分あると考える．