{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:23:00Z","timestamp":1776835380300,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the risk of aspiration associated with post\u2010swallow residue subsites in Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in bottle\u2010fed infants &lt;1\u2009year of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective matched\u2010pairs cohort study at an academic tertiary children's hospital. FEES and Videofluoroscopic Swallowing Study (VFSS) trials performed within the same infant &lt;5\u2009days apart were paired by matching bolus consistency and bottle flow rate. Positive aspiration was defined by the \u201cor rule\u201d in which aspiration is positive when either FEES or VFSS within a matched pair is positive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010seven FEES\u2010VFSS matched pairs from 29 patients (16 males; mean [SD] age, 2.9 [2.8] months) were included. The rate of positive aspiration, as defined by the \u201cor rule\u201d, was 59% (51\/87). In FEES, post\u2010swallow pyriform sinus residue was present in 16% (14\/87) and anterior commissure residue 27% (31\/87). Risk of positive aspiration was increased by pyriform sinus residue (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.9\u201319.3,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and anterior commissure residue in FEES (OR 2.5, 95% CI 1.1\u20136.1,<jats:italic>p<\/jats:italic>\u2009=\u20090.03). In the neonate subgroup, &lt;1\u2009month of age, multivariate\u2010adjusted analysis showed that anterior commissure residue had better diagnostic accuracy for aspiration than in older infants (overall 70% vs. 42%,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01; sensitivity 60% vs. 10%,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), whereas pyriform sinus residue had worse accuracy (overall 41% vs. 70%,<jats:italic>p<\/jats:italic>\u2009=\u20090.02; sensitivity 13% vs. 43%,<jats:italic>p<\/jats:italic>\u2009=\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that pyriform sinus and anterior commissure residue during infant FEES were associated with fivefold and twofold increased risk of aspiration, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3. Using a retrospective matched\u2010pairs cohort, this study assesses the diagnostic accuracy of post\u2010swallow residue in FEES for predicting aspiration.<jats:italic>Laryngoscope<\/jats:italic>, 134:1431\u20131436, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30954","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T13:24:56Z","timestamp":1692797096000},"page":"1431-1436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of Aspiration Increased by Post\u2010swallow Residue in Infant Fiberoptic Endoscopic Evaluation of Swallowing (<scp>FEES<\/scp>)"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3616-3583","authenticated-orcid":false,"given":"Julia","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Loma Linda University Loma Linda California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Okland","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Lucile Packard Children's Hospital Stanford Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Speiser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya","family":"Seetharaman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5352-7469","authenticated-orcid":false,"given":"Douglas","family":"Sidell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"},{"name":"Pediatric Aerodigestive and Airway Reconstruction Center and the Center for Pediatric Voice and Swallowing Disorders, Lucile Packard Children's Hospital Stanford California Stanford USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_AJSLP-19-00072"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2017.12.009"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-019-0438-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1599111"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000245"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949110000815"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110339"},{"key":"e_1_2_7_9_1","unstructured":"ArvedsonJC.Swallowing and feeding in infants and young children. 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