{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:54:48Z","timestamp":1788893688631,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Despite widespread use of high flow nasal cannula (HFNC) for respiratory support, the effect of HFNC on swallowing physiology is poorly understood. Flow rates that permit safe swallowing have not been established. We aim to assess if healthy individuals have diminished swallowing function and safety at high flow rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Repeated measures with planned data collection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Outpatient dysphagia clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Swallowing function in a cohort of healthy individuals was assessed using Flexible Endoscopic Evaluation of Swallowing (FEES). Participants' safety of swallowing was assessed with different textures under randomized rates of HFNC (0, 30, 40, 50, and 60 LPM). Swallowing trials included quantities of thin liquids, mildly\u2010thick liquids, and purees. Trials were scored using the Penetration\u2010Aspiration Scale (PAS). Pearson chi\u2010square tests were used to test for correlation between PAS result, flow rate, and consistency across each quantity of material.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven subjects were enrolled. Forty\u2010one percent were male with mean age of 34 years (11 standard deviation). Ninety\u2010nine percent (267\/270), 97% (n\u2009=\u2009263\/270), and 99% (399\/405) of 1 sip swallows, 3 sip swallows, and 5\u2009mL swallows, respectively, were safe. There was no significant correlation between swallow safety and flow rate using Pearson Chi\u2010Square test across all consistencies and across all quantities of materials (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). Of note, out of all subtrials, the thin liquid, 3 sips trial at 60 LPM, had the largest percent of unsafe swallows (14%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest rate of aspiration is not significantly affected by high flow nasal cannula in healthy individuals.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.673","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T07:33:15Z","timestamp":1707895995000},"page":"1372-1379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Assessment of Swallowing Function in Healthy Adults While Using High\u2010Flow Nasal Cannula"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7749-1301","authenticated-orcid":false,"given":"Alexander E.","family":"Graf","sequence":"first","affiliation":[{"name":"Department of Otolaryngology SUNY Downstate Health Sciences University Brooklyn USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alla","family":"Mehl","sequence":"additional","affiliation":[{"name":"Division of Speech\u2010Language Pathology, Orthopedics &amp; Rehabilitation Center Maimonides Health Brooklyn USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"De Costa","sequence":"additional","affiliation":[{"name":"Division of Speech\u2010Language Pathology, Orthopedics &amp; Rehabilitation Center Maimonides Health Brooklyn USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4788-7038","authenticated-orcid":false,"given":"Richard M.","family":"Rosenfeld","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology SUNY Downstate Health Sciences University Brooklyn USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2546-1757","authenticated-orcid":false,"given":"Sara","family":"Abu\u2010Ghanem","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology SUNY Downstate Health Sciences University Brooklyn USA"},{"name":"Department of Surgery, Division of Otolaryngology Maimonides Health Brooklyn USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201605-0916OC"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06312-y"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-1847-z"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200109000-00009"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051014"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-027523"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2016.11.004"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12790"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.58.2.152"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-015-9669-3"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03786-0"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_PERS-SIG13-2018-0019"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-016-1822-3"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_PERS-SIG13-2019-0013"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-020-10193-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2021.105477"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02414429"},{"key":"e_1_2_8_20_1","unstructured":"U.S. Food and Drug Administration. F&P Optiflow Nasal Oxygen Cannula with CO2Sampling Regulation Approval Letter March 16 2021. Retrieved May 1 2023 from https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf20\/K201723.pdf"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489414566267"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03118.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200308000-00023"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0507-6"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26419"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:10:51Z","timestamp":1760958651000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,14]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1002\/ohn.673"],"URL":"https:\/\/doi.org\/10.1002\/ohn.673","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,14]]},"assertion":[{"value":"2023-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}